Hypertension and its therapy for the prevention of Alzheimer's disease - Association between hypertension and cognitive function [Hypertonie und ihre behandlung in der pr?vention der Alzheimerkrankheit: Auswirkung der blutdruckwerte auf kognitive funktionen]

摘要

Arterial hypertension has been associated with dementia in later life. This association has not only been described for vascular dementia, but also for Alzheimer's disease. In elderly people and in patients with Alzheimer's disease the association between hypertension and cognitive function is uncertain; on the contrary; in these persons, low blood pressure has been linked to poor cognitive function and a more rapid cognitive decline. Several randomized studies analysed the potential benefits of antihypertensive therapy on dementia risk. However, the results of these studies are inconclusive. Up to now, a protective effect of antihypertensive therapy on the incidence of dementia has not been firmly established. A variety of methodological limitations may explain these discouraging results. Several observational studies indicate that in patients with dementia, lowering blood pressure could cause or worsen cognitive decline. However, the results of the larger randomized studies did not confirm these findings. In particular in patients with cerebrovascular lesions, elevated blood pressure should be treated gradually under close observation of cognitive functions.