Mansukhani Meghna P, Kolla Bhanu Prakash, Somers Virend K
Center for Sleep Medicine, Mayo Clinic, Rochester, MN, United States.
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.
Front Cardiovasc Med. 2019 Jul 10;6:96. doi: 10.3389/fcvm.2019.00096. eCollection 2019.
Hypertension and dementia are highly prevalent in the general population. Hypertension has been shown to be a risk factor for Alzheimer's dementia and vascular dementia. Sleep apnea, another common disorder, is strongly associated with hypertension and recent evidence suggests that it may also be linked with cognitive decline and dementia. It is possible that sleep apnea is the final common pathway linking hypertension to the development of dementia. This hypothesis merits further exploration as sleep apnea is readily treatable and such therapy could foreseeably delay or prevent the onset of dementia. At present, there is a paucity of therapeutic modalities that can prevent or arrest cognitive decline. In this review, we describe the associations between hypertension, dementia and sleep apnea, the pathophysiologic mechanisms underlying these associations, and the literature examining the impact of treatment of hypertension and sleep apnea on cognition. Potential areas of future investigation that may help advance our understanding of the magnitude and direction of the interaction between these conditions and the effects of treatment of high blood pressure and sleep apnea on cognition are highlighted.
高血压和痴呆症在普通人群中极为常见。高血压已被证明是阿尔茨海默病性痴呆和血管性痴呆的一个危险因素。睡眠呼吸暂停是另一种常见疾病，与高血压密切相关，最近的证据表明它也可能与认知能力下降和痴呆症有关。睡眠呼吸暂停有可能是将高血压与痴呆症发展联系起来的最终共同途径。这一假说值得进一步探究，因为睡眠呼吸暂停易于治疗，而且这种治疗有望延缓或预防痴呆症的发作。目前，能够预防或阻止认知能力下降的治疗方法很少。在这篇综述中，我们描述了高血压、痴呆症和睡眠呼吸暂停之间的关联，这些关联背后的病理生理机制，以及研究高血压和睡眠呼吸暂停治疗对认知影响的文献。文中突出了未来可能有助于推进我们对这些病症之间相互作用的程度和方向以及高血压和睡眠呼吸暂停治疗对认知影响的理解的潜在研究领域。
