The Association between Hypertension and Dementia in the Elderly
Hypertension (HT) and dementia are common disorders in the elderly. HT in the elderly is associated with increased occurrence rates of dementia including Alzheimer's disease (AD) and vascular dementia (VaD). In connection to this, some studies have suggested that HT in old age correlates with t...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | International Journal of Hypertension |
| Online Access: | http://dx.doi.org/10.1155/2012/320648 |
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| author | Michiya Igase Katsuhiko Kohara Tetsuro Miki |
| author_facet | Michiya Igase Katsuhiko Kohara Tetsuro Miki |
| author_sort | Michiya Igase |
| collection | DOAJ |
| description | Hypertension (HT) and dementia are common disorders in the elderly. HT in the elderly is associated with increased occurrence rates of dementia including Alzheimer's disease (AD) and vascular dementia (VaD). In connection to this, some studies have suggested that HT in old age correlates with the pathogenesis of dementia. Since HT is potentially reversible, a number of randomized trials have examined whether antihypertensive treatment may help in preventing dementia occurrence. We review five studies, all using subjects 60 years or older, which investigated different antihypertensive pharmacological treatments. Data from two trials (Syst-Eur, PROGRESS) open the way toward the prevention of dementia (AD or VaD) by antihypertensive treatments. In the Syst-Eur study, with the dihydropyridine calcium antagonists, a reduction in both types of dementia was demonstrated (risk reduction 55%). The PROGRESS study showed that the use of angiotensin-converting enzyme inhibitors (ACEIs), with or without diuretics, resulted in decrease incidence of stroke-related dementia (risk reduction 19%), but dementia without stroke was not reduced. In contrast, the SHEP trial, treatment with a chlorthalidone-based antihypertensive regimen, did not significantly reduced the incidence of dementia. The SCOPE study (candesartan or hydrochlorothiazide versus placebo) and the HYVET-COG study (indapamide or perindopril versus placebo) found no significant difference between the active treatment and placebo group on the incidence of dementia. We found conflicting results regarding treatment benefits in dementia prevention. Recent clinical trials and studies on animal models suggest that blockades of RAS system could have reduced cognitive decline seen in Alzheimer's disease and vascular dementia. Future trials primarily designed to investigate the effects of antihypertensive agents on impaired cognition are needed. |
| format | Article |
| id | doaj-art-b368fa05d4ac47fe97f48377632093b0 |
| institution | Kabale University |
| issn | 2090-0384 2090-0392 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Hypertension |
| spelling | doaj-art-b368fa05d4ac47fe97f48377632093b02025-02-03T06:07:28ZengWileyInternational Journal of Hypertension2090-03842090-03922012-01-01201210.1155/2012/320648320648The Association between Hypertension and Dementia in the ElderlyMichiya Igase0Katsuhiko Kohara1Tetsuro Miki2Department of Geriatric Medicine, Ehime University Graduate School of Medicine, Toon City, Ehime 791-0295, JapanDepartment of Geriatric Medicine, Ehime University Graduate School of Medicine, Toon City, Ehime 791-0295, JapanDepartment of Geriatric Medicine, Ehime University Graduate School of Medicine, Toon City, Ehime 791-0295, JapanHypertension (HT) and dementia are common disorders in the elderly. HT in the elderly is associated with increased occurrence rates of dementia including Alzheimer's disease (AD) and vascular dementia (VaD). In connection to this, some studies have suggested that HT in old age correlates with the pathogenesis of dementia. Since HT is potentially reversible, a number of randomized trials have examined whether antihypertensive treatment may help in preventing dementia occurrence. We review five studies, all using subjects 60 years or older, which investigated different antihypertensive pharmacological treatments. Data from two trials (Syst-Eur, PROGRESS) open the way toward the prevention of dementia (AD or VaD) by antihypertensive treatments. In the Syst-Eur study, with the dihydropyridine calcium antagonists, a reduction in both types of dementia was demonstrated (risk reduction 55%). The PROGRESS study showed that the use of angiotensin-converting enzyme inhibitors (ACEIs), with or without diuretics, resulted in decrease incidence of stroke-related dementia (risk reduction 19%), but dementia without stroke was not reduced. In contrast, the SHEP trial, treatment with a chlorthalidone-based antihypertensive regimen, did not significantly reduced the incidence of dementia. The SCOPE study (candesartan or hydrochlorothiazide versus placebo) and the HYVET-COG study (indapamide or perindopril versus placebo) found no significant difference between the active treatment and placebo group on the incidence of dementia. We found conflicting results regarding treatment benefits in dementia prevention. Recent clinical trials and studies on animal models suggest that blockades of RAS system could have reduced cognitive decline seen in Alzheimer's disease and vascular dementia. Future trials primarily designed to investigate the effects of antihypertensive agents on impaired cognition are needed.http://dx.doi.org/10.1155/2012/320648 |
| spellingShingle | Michiya Igase Katsuhiko Kohara Tetsuro Miki The Association between Hypertension and Dementia in the Elderly International Journal of Hypertension |
| title | The Association between Hypertension and Dementia in the Elderly |
| title_full | The Association between Hypertension and Dementia in the Elderly |
| title_fullStr | The Association between Hypertension and Dementia in the Elderly |
| title_full_unstemmed | The Association between Hypertension and Dementia in the Elderly |
| title_short | The Association between Hypertension and Dementia in the Elderly |
| title_sort | association between hypertension and dementia in the elderly |
| url | http://dx.doi.org/10.1155/2012/320648 |
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