Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2007;9(1):61-70.
doi: 10.31887/DCNS.2007.9.1/ctzourio.

Hypertension, cognitive decline, and dementia: an epidemiological perspective

Christophe Tzourio  1
Affiliations
Review

Hypertension, cognitive decline, and dementia: an epidemiological perspective

Christophe Tzourio. Dialogues Clin Neurosci. 2007.

Abstract
in English, Spanish, French

Hypertension is a known risk factor for stroke, and thus for vascular dementia. However, recent large observational studies have suggested that high blood pressure may also play a role in Alzheimer's disease. The mechanisms linking hypertension to Alzheimer's disease remain to be elucidated, but white matter lesions seen on cerebral magnetic resonance imaging appear to be a good marker of this association. It is not yet clearly established whether lowering blood pressure reduces the risk of white matter lesions and dementia, so large trials dealing with this question are eagerly awaited. These future trials could confirm the hope that, by lowering blood pressure, we may have a preventive treatment for dementia. This issue is of major importance, as the number of cases of dementia is expected to rise

La hipertensión arterial es un factor de riesgo conocido para el accidente vascular encefálico y en consecuencia para la demencia vascular. Sin embargo, extensos estudios observacíonales recientes han sugerido que la presión arterial elevada puede jugar también un papel en la Enfermedad de Alzheimer. Los mecanismos que relacionan la hipertensión con la Enfermedad de Alzheimer aun deben ser dilucidados, pero las lesiones en la sustancia blanca que se han observado en la resonancia magnética cerebral parecen ser buenos marcadores de esta asociación. Aun no está claramente establecido que la reducción de la presión arterial disminuya el riesgo de lesiones en la sustancia blanca y de demencia, por lo que se espera con gran ilusión que grandes ensayos clínicos traten de aclarar esta pregunta. Estos futuros ensayos clínicos podrían confirmar la esperanza quef al reducir la presión arterial, se pueda contar con un tratamiento preventivo para la demencia. Este tema es de la mayor importancia ya que se espera que el número de casos de demencia aumente marcadamente en un futuro cercano.

L'hypertension est un facteur de risque connu d'accident vasculaire cérébral et donc pour la démence vasculaire. Cependant le rôle éventuel d'une pression artérielle élevée dans la maladie d'Alzheimer a été évoqué dans des études récentes observationnelles portant sur de grands effectifs. Les mécanismes liant l'hypertension à la maladie d'Alzheimer demandent à être approfondis mais des lésions de la substance blanche vues à l'IRM (imagerie par résonance magnétique) semblent être un bon marqueur de cette association. Il n'est pas encore clairement établi que la baisse de la pression artérielle diminue le risque de lésions de la substance blanche et de démence. De larges études consacrées à cette question sont éminemment attendues. Elles pourraient confirmer l'espoir d'un traitement préventif de la démence par diminution de la pression artérielle. Il s'agit d'un problème d'importance majeure du fait que le nombre de cas de démence est amené à augmenter considérablement dans un futur proche.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. Diagrammatic representation of the consequences of hypertension on the brain. WML, white matter lesions
Figure 2.
Figure 2.. White matter lesions on cerebral MRI. Cerebral MRI of two women 67 years of age without (on the left) and with (on the right) hypertension. The subject with hypertension had several deep and periventricular white matter lesions (arrows). MRI, magnetic resonance imaging
See this image and copyright information in PMC

References

    1. Ferri CP., Prince M., Brayne C., et al. Global prevalence of dementia: a Delphi consensus study. Lancet. 2005;366:2112–2117. - PMC - PubMed
    1. Ritchie K., Kildea D. Is senile dementia “age-related” or “ageing-related”? ence from meta-analysis of dementia prevalence in the oldest old. Lancet. 1995;346:931–934. - PubMed
    1. Tatemichi TK., Paik M., Bagiella E., et al. Risk of dementia after stroke in a hospitalized cohort: results of a longitudinal study. Neurology. 1994;44:1885–1891. - PubMed
    1. Zhu L., Fratiglioni L., Guo ZC., et al. Incidence of dementia in relation to stroke and the apolipoprotein E epsilon 4 allele in the very old: findings from a population-based longitudinal study. Stroke. 2000;31:53–60. - PubMed
    1. Kokmen E., Whisnant JP., O'Fallon WM., Chu CP., Beard CM. Dementia after ischemic stroke: a population-based study in Rochester, Minnesota (1960-1984). Neurology. 1996;46:154–159. - PubMed

MeSH terms

Substances