Association of Hypertension with Different Cognitive Disorders

Abstract

This literature review explores the association between hypertension and major neurocognitive disorders, including delirium, Alzheimer's disease, vascular dementia, Lewy body dementia, and frontotemporal dementia, which contribute significantly to global mortality and morbidity. Hypertension is a potentially modifiable risk factor for cognitive decline, as it contributes to the progression of neurodegenerative pathologies via vascular damage, inflammation, and the disruption of the blood-brain barrier. Despite this, the effectiveness of antihypertensive treatments in preventing or alleviating cognitive decline remains contentious. While some research highlights the potential benefits of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, other studies show inconsistent results, complicated by variations in hypertension definitions, diagnostic criteria for cognitive disorders, and confounding factors like medication adherence. Furthermore, the complex bidirectional relationship between hypertension and major neurocognitive disorders warrants more investigation, as cognitive decline can exacerbate cardiovascular risks through heightened inflammatory responses and compromised autonomic regulation. This review underscores the need for prospective, long-term studies to elucidate the relationships between hypertension and cognitive disorders and to evaluate the potential therapeutic benefits of antihypertensive treatments.

Keywords: Alzheimer’s; Lewy body; antihypertensive; dementia; frontotemporal; hypertension; vascular.