Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
Psychophysiology. 2021 Jul;58(7):e13654. doi: 10.1111/psyp.13654. Epub 2020 Aug 24.
The majority of individuals over an age of 60 have hypertension. Elevated blood pressure and older age are associated with very similar changes in brain structure and function. We review the parallel brain changes associated with increasing age and blood pressure. This review focuses on joint associations of aging and elevated blood pressure with neuropsychological function, regional cerebral blood flow responses to cognitive and metabolic challenges, white matter disruptions, grey matter volume, cortical thinning, and neurovascular coupling. Treatment of hypertension ameliorates many of these changes but fails to reverse them. Treatment of hypertension itself appears more successful with better initial brain function. We show evidence that sympathetic and renal influences known to increase blood pressure also impact brain integrity. Possible central mechanisms contributing to the course of hypertension and aging are then suggested. An emphasis is placed on psychologically relevant factors: stress, cardiovascular reactions to stress, and diet/obesity. The contribution of some of these factors to biological aging remains unclear and may provide a starting point for defining the independent and interacting effects of aging and increasing blood pressure on the brain.
大多数 60 岁以上的人都患有高血压。血压升高和年龄增长与大脑结构和功能的非常相似的变化有关。我们回顾了与年龄增长和血压升高相关的平行脑变化。这篇综述侧重于衰老和血压升高与神经心理学功能、认知和代谢挑战的区域脑血流反应、白质破坏、灰质体积、皮质变薄和神经血管耦联的联合关联。高血压的治疗可以改善其中的许多变化，但不能逆转这些变化。治疗高血压本身似乎在初始脑功能更好的情况下更成功。我们有证据表明，已知会升高血压的交感神经和肾脏影响也会影响大脑的完整性。然后提出了可能导致高血压和衰老过程的中枢机制。强调了与心理相关的因素：压力、对压力的心血管反应以及饮食/肥胖。这些因素中的一些对生物衰老的贡献仍不清楚，可能为定义衰老和血压升高对大脑的独立和相互作用影响提供了一个起点。
