Abstract
Vascular pathology impairs cognition and impaired cognition increases the risk of
dementia. Hypertension is arguably the vascular risk factor that can be reverted best.
Here we estimated the effect magnitude of hypertension by determining the variance
in cognition explained by systolic blood pressure (sBP) in non-demented community-dwelling
individuals.
We recruited 525 individuals (mean age 65, range 40–85) selected from the city registry
of Muenster, Germany, measured cognitive performance with a comprehensive test battery
and assessed vascular risk based on glycosylated hemoglobin, serum cholesterol, high
sensitive C-reactive protein, body mass index, smoking pack years, and blood pressure.
Including gender and education as well as the vascular risk factors, multiple linear
regression analysis for different age groups showed that in midlife age groups systolic
blood pressure explained up to 11% of the variance in cognitive performance.
These findings suggest that in non-demented community-dwelling individuals hypertension
may account for one tenth of cognitive impairment and thus for an increased risk for
dementia.
Keywords
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References
- Brain infarction and the clinical expression of Alzheimer disease. The Nun Study.JAMA. 1997; 277: 813-817
- Cerebral infarctions and the likelihood of dementia from Alzheimer disease pathology.Neurology. 2004; 62: 1148-1155
Vermeer SE, Prins ND, Den Heijer T, Hofman A, Koudstaal PJ, Breteler MM. Silent brain infarcts and the risk of dementia and cognitive decline. N Engl J Med 2003 Mar 27;348 (13):1215 -22 2003; 348:1215–1222.
- Cerebrovascular disease and threshold for dementia in the early stages of Alzheimer's disease.Lancet. 1999; 354: 919-920
- Beitrag vaskulärer Faktoren zur Demenz.Dtsch Aerzteblatt. 2004; 101: 2185-2189
- Looking backward to move forward: early detection of neurodegenerative disorders.Science. 2003; 302: 830-834
- Neuropsychological measures in normal individuals that predict subsequent cognitive decline.Arch Neurol. 2007; 64: 862-871
- Blood pressure and late-life cognitive function change: a biracial longitudinal population study.Neurology. 2004; 62: 2021-2024
- Prevalence and classification of mild cognitive impairment in the cardiovascular health study cognition study: part 1.Arch Neurol. 2003; 60: 1385-1389
- Left ventricular mass, blood pressure, and lowered cognitive performance in the Framingham offspring.Hypertension. 2007; 49: 439-445
- Cognitive decline in individuals with high blood pressure: a longitudinal study in the elderly. EVA Study Group. Epidemiology of Vascular Aging.Neurology. 1999; 53: 1948-1952
- Vascular pathologies and cognition in a population-based cohort of elderly people.J Neurol Sci. 2004; 226: 13-17
- 15-year longitudinal study of blood pressure and dementia.Lancet. 1996; 347: 1141-1145
- Atherosclerosis, apolipoprotein E, and prevalence of dementia and Alzheimer's disease in the Rotterdam Study.Lancet. 1997; 349: 151-154
- Hypertension is related to cognitive impairment: a 20-year follow-up of 999 men.Hypertension. 1998; 31: 780-786
- Subcortical infarcts, Alzheimer's disease pathology, and memory function in older persons.Ann Neurol. 2007; 62: 59-66
- Less atherosclerosis and lower blood pressure for a meaningful life perspective with more brain.Hypertension. 2007; 49: 389-400
- High-normal blood pressure is associated with poor cognitive performance.Hypertension. 2008; 51: 663-668
- Nonlinear relations of blood pressure to cognitive function: the Baltimore Longitudinal Study of Aging.Hypertension. 2005; 45: 374-379
- The cross-sectional association between blood pressure and Alzheimer's disease in a biracial community population of older persons.J Gerontol A Biol Sci Med Sci. 2000; 55: M130-M136
- Low blood pressure and dementia in elderly people: the Kungsholmen project.BMJ. 1996; 312: 805-808
- Low blood pressure and risk of dementia in the Kungsholmen project: a 6-year follow-up study.Arch Neurol. 2003; 60: 223-228
- Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician.J Psychiatr Res. 1975; 12: 189-198
- Beck-Depressions-Inventar (BDI).Hogrefe, Göttingen1995
- Neuropsychological assessment.4 ed. Oxford Univ. Press, New York, Oxford2004
- SPSS for Windows 15.0. SPSS Inc., Chicago, Il, USA2006
- The age-dependent relation of blood pressure to cognitive function and dementia.Lancet Neurol. 2005; 4: 487-499
- Degenerative changes in epinephrine tonic vasomotor neurons in Alzheimer's disease.Brain Res. 1994; 661: 35-42
- Blood pressure regulation in Alzheimer's disease.J Auton Nerv Syst. 1994; 48: 65-71
- Brain reserve and cognitive decline: a non-parametric systematic review.Psychol Med. 2006; 36: 1065-1073
- The prevention of dementia with antihypertensive treatment: new evidence from the Systolic Hypertension in Europe (Syst-Eur) study.Arch. Intern. Med. 2002; 162: 2046-2052
- Occurrence and progression of dementia in a community population aged 75 years and older: relationship of antihypertensive medication use.Arch Neurol. 1999; 56: 991-996
- Low blood pressure and the risk of dementia in very old individuals.Neurology. 2003; 61: 1667-1672
- Treating hypertension in the older person: an evaluation of the association of blood pressure level and its reduction with cognitive performance.J Hypertens. 1990; 8: 147-152
- Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group.JAMA. 1991; 265: 3255-3264
- The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double–blind intervention trial.J Hypertens. 2003; 21: 875-886
- Systematic review: blood pressure lowering in patients without prior cerebrovascular disease for prevention of cognitive impairment and dementia.J Neurol Neurosurg Psychiatry. 2008; 79: 4-5
Article info
Publication history
Published online: March 23, 2009
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© 2009 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
