The relationship between blood pressure and cognitive function.
The relationship between blood pressure (BP) and cognitive outcomes in elderly adults has implications for global health care. Both hypertension and hypotension affect brain perfusion and worsen cognitive outcomes. The presence of hypertension and other vascular risk factors has been associated with decreased performance in executive function and attention tests. Cerebrovascular reserve has emerged as a potential biomarker for monitoring pressure-perfusion-cognition relationships. A decline in vascular reserve capacity can lead to impaired neurovascular coupling and decreased cognitive ability. Endothelial dysfunction, microvascular disease, and mascrovascular disease in midlife could also have an important role in the manifestations and severity of multiple medical conditions underlying cognitive decline late in life. However, questions remain about the role of antihypertensive therapies for long-term prevention of cognitive decline. In this Review, we address the underlying pathophysiology and the existing evidence supporting the role of vascular factors in late-life cognitive decline.
Division of Gerontology, Beth Israel Deaconess Medical Center and Harvard Medical School, 110 Francis Street, LMOB Suite 1b, Boston, MA 02215, USA. vnovak@bidmc.harvard.edu
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D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D003071:Cognition / Q000187:drug effects; D003072:Cognition Disorders / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D007022:Hypotension / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors
D000959:Antihypertensive Agents