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      Impact of Hypertension on Cognitive Function : A Scientific Statement From the American Heart Association

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          Abstract

          Background

          Age-related dementia, most commonly caused by Alzheimer disease or cerebrovascular factors (vascular dementia), is a major public health threat. Chronic arterial hypertension is a well-established risk factor for both types of dementia, but the link between hypertension and its treatment and cognition remains poorly understood. In this scientific statement, a multidisciplinary team of experts examines the impact of hypertension on cognition to assess the state of the knowledge, to identify gaps, and to provide future directions.

          Methods

          Authors with relevant expertise were selected to contribute to this statement in accordance with the American Heart Association conflict-of-interest management policy. Panel members were assigned topics relevant to their areas of expertise, reviewed the literature, and summarized the available data.

          Results

          Hypertension disrupts the structure and function of cerebral blood vessels, leads to ischemic damage of white matter regions critical for cognitive function, and may promote Alzheimer pathology. There is strong evidence of a deleterious influence of midlife hypertension on late-life cognitive function, but the cognitive impact of late-life hypertension is less clear. Observational studies demonstrated a cumulative effect of hypertension on cerebrovascular damage, but evidence from clinical trials that antihypertensive treatment improves cognition is not conclusive.

          Conclusions

          After carefully reviewing the literature, the group concluded that there were insufficient data to make evidence-based recommendations. However, judicious treatment of hypertension, taking into account goals of care and individual characteristics (eg, age and comorbidities), seems justified to safeguard vascular health and, as a consequence, brain health.

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          Author and article information

          Journal
          7906255
          4217
          Hypertension
          Hypertension
          Hypertension (Dallas, Tex. : 1979)
          0194-911X
          1524-4563
          15 February 2017
          10 October 2016
          December 2016
          22 March 2017
          : 68
          : 6
          : e67-e94
          Article
          PMC5361411 PMC5361411 5361411 nihpa852058
          10.1161/HYP.0000000000000053
          5361411
          27977393
          e70387e6-e236-45f8-a26d-9829c9535bb5

          Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are located at http://www.heart.org/HEARTORG/General/Copyright-Permission-Guidelines_UCM_300404_Article.jsp. A link to the “Copyright Permissions Request Form” appears on the right side of the page.

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          Categories
          Article

          AHA Scientific Statements,Alzheimer disease,biomarkers,blood pressure,clinical trials,neuroimaging,therapy,vascular cognitive impairment

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