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Review
. 2022 Jul 1;37(4):326-333.
doi: 10.1097/HCO.0000000000000975.

Hypertension and cognitive function: a review of life-course factors and disparities

Ileana De Anda-Duran  1 , Sara G Woltz  1 , Caryn N Bell  1 , Lydia A Bazzano  1   2   3
Affiliations
Review

Hypertension and cognitive function: a review of life-course factors and disparities

Ileana De Anda-Duran et al. Curr Opin Cardiol. .

Abstract

Purpose of review: Dementia is a life-course condition with modifiable risk factors many from cardiovascular (CV) origin, and disproportionally affects some race/ethnic groups and underserved communities in the USA. Hypertension (HTN) is the most common preventable and treatable condition that increases the risk for dementia and exacerbates dementia pathology. Epidemiological studies beginning in midlife provide strong evidence for this association. This study provides an overview of the differences in the associations across the lifespan, and the role of social determinants of health (SDoH).

Recent findings: Clinical trials support HTN management in midlife as an avenue to lower the risk for late-life cognitive decline. However, the association between HTN and cognition differs over the life course. SDoH including higher education modify the association between HTN and cognition which may differ by race and ethnicity. The role of blood pressure (BP) variability, interactions among CV risk factors, and cognitive assessment modalities may provide information to better understand the relationship between HTN and cognition.

Summary: Adopting a life-course approach that considers SDoH, may help develop tailored interventions to manage HTN and prevent dementia syndromes. Where clinical trials to assess BP management from childhood to late-life are not feasible, observational studies remain the best available evidence.

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Conflict of interest statement

Conflict of interest:

The authors disclose no conflicts of interest.

Figures

Figure 1.
Figure 1.
Life-course factors impacting hypertension and cognition Adapted from Glymour and Manly, 2008; Figure 1. depicts neurobiological parameters, and social factors impacting hypertension, cognitive function and the association between both across the life-course, from the prenatal period to old age. Social factors are divided according to their mediator role in the causal pathway to cognitive outcomes.
See this image and copyright information in PMC

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