The effects of blood pressure lowering on development of cognitive impairment and dementia in patients without apparent prior cerebrovascular disease

Effects of different antihypertensive medication groups on cognitive function in older patients: A systematic review

“…We did not calculate the mean differences among the different RCTs because this is a systematic review (a meta-analysis would be the next logical step), but in any case our results support those of that network meta-analysis. Our results are not supported by two Cochrane systematic reviews in which the combined results of the four trials reported a non-significant difference in the incidence of dementia between treatment and placebo (236/7767 versus 259/7660, Odds Ratio (OR) = 0.89, 95% CI 0.74–1.07) [4,5]. In addition to our systematic review, the study published by Yasar et al [23] confirmed our results.…”

“…This systematic review provides additional evidence to previously published meta-analyses in older patients without apparent prior cerebrovascular disease [1–5]. The current review found that ARBs have the most positive effect on cognition in elderly patients without apparent prior cerebrovascular disease, except mild cognitive impairment, which is often hard to exclude.…”

Effects of different antihypertensive medication groups on cognitive function in older patients: A systematic review

“…We did not calculate the mean differences among the different RCTs because this is a systematic review (a meta-analysis would be the next logical step), but in any case our results support those of that network meta-analysis. Our results are not supported by two Cochrane systematic reviews in which the combined results of the four trials reported a non-significant difference in the incidence of dementia between treatment and placebo (236/7767 versus 259/7660, Odds Ratio (OR) = 0.89, 95% CI 0.74–1.07) [4,5]. In addition to our systematic review, the study published by Yasar et al [23] confirmed our results.…”

“…This systematic review provides additional evidence to previously published meta-analyses in older patients without apparent prior cerebrovascular disease [1–5]. The current review found that ARBs have the most positive effect on cognition in elderly patients without apparent prior cerebrovascular disease, except mild cognitive impairment, which is often hard to exclude.…”

Do Overweight, Arterial Hypertension and Type 2 Diabetes Worsen Cognitive Impairment in Patients with Alcohol Use Disorders?

“…In a sample of hypertensive patients, assessed over a successful one-year anti-hypertensive treatment, no significant anatomical modifications were observed [44]. This is consistent with a critical review which claimed that there is no convincing evidence from randomized controlled trials that lowering blood pressure prevents the development of cognitive impairment [45]. Altogether, an alcohol-induced reduction in inflammation appears to be insufficient to improve the patient's cognitive status, as vascular lesions remain unchanged.…”

Risk Factors of Transition from Normal Cognition to Mild Cognitive Disorder: The PATH through Life Study

“…These findings partly contradict previous findings showing (1) a decreased risk of cognitive decline [35] and a milder occurrence of Alzheimer pathology [36] in individuals taking anti-hypertensive medication, and (2) an increased risk of developing dementia in hypertensive individuals [37] , and should be interpreted cautiously. However, a Cochrane review [38] found no evidence of association between blood pressure-lowering treatments and the risk of developing dementia or cognitive impairment and we have not found studies reporting a risk associated with heightened diastolic blood pressure when other relevant variables were controlled. In addition, in the oldest-old, it was found that higher systolic blood pressure was associated with better cognition [39] and in another longitudinal study investigating the relationship between blood pressure and late-life cognitive change, no linear association was found between systolic or diastolic blood pressure and cognition but a curvilinear relationship between diastolic blood pressure and cognition was present, showing an association between both high and low diastolic blood pressure and decreased cognition [40] .…”

Effects of different antihypertensive medication groups on cognitive function in older patients: A systematic review

“…We did not calculate the mean differences among the different RCTs because this is a systematic review (a meta-analysis would be the next logical step), but in any case our results support those of that network meta-analysis. Our results are not supported by two Cochrane systematic reviews in which the combined results of the four trials reported a non-significant difference in the incidence of dementia between treatment and placebo (236/7767 versus 259/7660, Odds Ratio (OR) = 0.89, 95% CI 0.74–1.07) [4,5]. In addition to our systematic review, the study published by Yasar et al [23] confirmed our results.…”

“…This systematic review provides additional evidence to previously published meta-analyses in older patients without apparent prior cerebrovascular disease [1–5]. The current review found that ARBs have the most positive effect on cognition in elderly patients without apparent prior cerebrovascular disease, except mild cognitive impairment, which is often hard to exclude.…”

Do Overweight, Arterial Hypertension and Type 2 Diabetes Worsen Cognitive Impairment in Patients with Alcohol Use Disorders?

“…In a sample of hypertensive patients, assessed over a successful one-year anti-hypertensive treatment, no significant anatomical modifications were observed [44]. This is consistent with a critical review which claimed that there is no convincing evidence from randomized controlled trials that lowering blood pressure prevents the development of cognitive impairment [45]. Altogether, an alcohol-induced reduction in inflammation appears to be insufficient to improve the patient's cognitive status, as vascular lesions remain unchanged.…”

Risk Factors of Transition from Normal Cognition to Mild Cognitive Disorder: The PATH through Life Study

“…These findings partly contradict previous findings showing (1) a decreased risk of cognitive decline [35] and a milder occurrence of Alzheimer pathology [36] in individuals taking anti-hypertensive medication, and (2) an increased risk of developing dementia in hypertensive individuals [37] , and should be interpreted cautiously. However, a Cochrane review [38] found no evidence of association between blood pressure-lowering treatments and the risk of developing dementia or cognitive impairment and we have not found studies reporting a risk associated with heightened diastolic blood pressure when other relevant variables were controlled. In addition, in the oldest-old, it was found that higher systolic blood pressure was associated with better cognition [39] and in another longitudinal study investigating the relationship between blood pressure and late-life cognitive change, no linear association was found between systolic or diastolic blood pressure and cognition but a curvilinear relationship between diastolic blood pressure and cognition was present, showing an association between both high and low diastolic blood pressure and decreased cognition [40] .…”

Effects of different antihypertensive medication groups on cognitive function in older patients: A systematic review

“…We did not calculate the mean differences among the different RCTs because this is a systematic review (a meta-analysis would be the next logical step), but in any case our results support those of that network meta-analysis. Our results are not supported by two Cochrane systematic reviews in which the combined results of the four trials reported a non-significant difference in the incidence of dementia between treatment and placebo (236/7767 versus 259/7660, Odds Ratio (OR) = 0.89, 95% CI 0.74–1.07) [4,5]. In addition to our systematic review, the study published by Yasar et al [23] confirmed our results.…”

“…This systematic review provides additional evidence to previously published meta-analyses in older patients without apparent prior cerebrovascular disease [1–5]. The current review found that ARBs have the most positive effect on cognition in elderly patients without apparent prior cerebrovascular disease, except mild cognitive impairment, which is often hard to exclude.…”

Do Overweight, Arterial Hypertension and Type 2 Diabetes Worsen Cognitive Impairment in Patients with Alcohol Use Disorders?

“…In a sample of hypertensive patients, assessed over a successful one-year anti-hypertensive treatment, no significant anatomical modifications were observed [44]. This is consistent with a critical review which claimed that there is no convincing evidence from randomized controlled trials that lowering blood pressure prevents the development of cognitive impairment [45]. Altogether, an alcohol-induced reduction in inflammation appears to be insufficient to improve the patient's cognitive status, as vascular lesions remain unchanged.…”

Risk Factors of Transition from Normal Cognition to Mild Cognitive Disorder: The PATH through Life Study

“…These findings partly contradict previous findings showing (1) a decreased risk of cognitive decline [35] and a milder occurrence of Alzheimer pathology [36] in individuals taking anti-hypertensive medication, and (2) an increased risk of developing dementia in hypertensive individuals [37] , and should be interpreted cautiously. However, a Cochrane review [38] found no evidence of association between blood pressure-lowering treatments and the risk of developing dementia or cognitive impairment and we have not found studies reporting a risk associated with heightened diastolic blood pressure when other relevant variables were controlled. In addition, in the oldest-old, it was found that higher systolic blood pressure was associated with better cognition [39] and in another longitudinal study investigating the relationship between blood pressure and late-life cognitive change, no linear association was found between systolic or diastolic blood pressure and cognition but a curvilinear relationship between diastolic blood pressure and cognition was present, showing an association between both high and low diastolic blood pressure and decreased cognition [40] .…”