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心血管疾病与痴呆症:探索交叉点、风险及治疗挑战

Cardiovascular Disease and Dementia: Exploring Intersections, Risks, and Therapeutic Challenges.

作者信息

Huang Lillian, Meir Juliet, Frishman William H, Aronow Wilbert S

机构信息

From the Department of Medicine, New York Medical College, Valhalla, NY.

Department of Medicine, Long Island Jewish Hospital, Queens, NY.

出版信息

Cardiol Rev. 2024 May 24. doi: 10.1097/CRD.0000000000000730.

Abstract

This review examines the complex bidirectional relationship between cardiovascular disease and various dementia subtypes, including Alzheimer's disease, vascular dementia, Lewy body dementia, and frontotemporal dementia. Traditional cardiovascular risk factors such as hypertension, coronary artery disease, arrhythmia, and diabetes mellitus are strongly linked to the development of dementia. Emerging evidence indicates that cognitive decline can exacerbate cardiovascular risks through heightened inflammatory responses and compromised autonomic regulation. Additionally, this review explores trials that investigate the impact of cardiovascular medications, such as antihypertensive and statin therapies, on cognitive outcomes, as well as studies examining how dementia treatments like anticholinesterases affect cardiovascular health. This review emphasizes the importance of early identification of at-risk individuals, integrated care approaches, and lifestyle interventions aimed at reducing both cardiovascular disease and dementia risk, ultimately aiming to enhance patient outcomes and quality of life.

摘要

本综述探讨了心血管疾病与各种痴呆亚型之间复杂的双向关系,这些痴呆亚型包括阿尔茨海默病、血管性痴呆、路易体痴呆和额颞叶痴呆。传统的心血管危险因素,如高血压、冠状动脉疾病、心律失常和糖尿病,与痴呆的发生密切相关。新出现的证据表明,认知功能下降可通过增强炎症反应和损害自主神经调节而加剧心血管风险。此外,本综述还探讨了研究心血管药物(如抗高血压药和他汀类药物治疗)对认知结果影响的试验,以及研究抗胆碱酯酶等痴呆治疗方法如何影响心血管健康的研究。本综述强调了早期识别高危个体、综合护理方法以及旨在降低心血管疾病和痴呆风险的生活方式干预的重要性,最终目标是改善患者的预后和生活质量。

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