Khan Adam D, Elnagar Sara, Eltayeb Mohamed, Baluch Shariq K, Kumar Ajay, Kumari Madhurta, Kumari Muskan, Fareed Muhammad Usman, Rehman Abdur, Shehryar Abdullah
Internal Medicine, Frontier Medical & Dental College, Abbottabad, PAK.
Internal Medicine, NewYork-Presbyterian Queens Hospital, New York City, USA.
Cureus. 2024 Jul 23;16(7):e65194. doi: 10.7759/cureus.65194. eCollection 2024 Jul.
Hypertension, a major risk factor for cardiovascular diseases, has also been linked to cognitive decline and Alzheimer's disease (AD). This systematic review synthesizes the current evidence on how managing hypertension may influence cognitive health, particularly among elderly populations and those with cognitive impairments. By analyzing data from randomized controlled trials (RCTs), clinical trials, and cross-sectional studies, we evaluated the efficacy of various interventions, including pharmacological treatments, lifestyle modifications, and multidomain approaches that address blood pressure (BP) variability and intensive versus standard blood pressure control. Our findings reveal that effective blood pressure management can mitigate cognitive decline and potentially alter the course of Alzheimer's disease. However, the results also highlight complexities, such as the risk of adverse effects from intensive blood pressure control on cognitive processing and hippocampal volume. This review underscores the need for tailored hypertension management strategies that balance cardiovascular health with cognitive outcomes, suggesting that stabilizing blood pressure variability could play a crucial role. Future research should focus on longitudinal studies to refine these management strategies and enhance treatment guidelines, improving overall outcomes for patients at risk of cognitive decline.
高血压是心血管疾病的主要危险因素，还与认知能力下降和阿尔茨海默病（AD）有关。本系统综述综合了当前关于控制高血压如何影响认知健康的证据，特别是在老年人群和认知障碍人群中。通过分析随机对照试验（RCT）、临床试验和横断面研究的数据，我们评估了各种干预措施的疗效，包括药物治疗、生活方式改变以及解决血压（BP）变异性和强化与标准血压控制的多领域方法。我们的研究结果表明，有效的血压管理可以减轻认知能力下降，并有可能改变阿尔茨海默病的病程。然而，结果也凸显了一些复杂性，如强化血压控制对认知加工和海马体积产生不良反应的风险。本综述强调了需要制定量身定制的高血压管理策略，以平衡心血管健康与认知结果，表明稳定血压变异性可能起着关键作用。未来的研究应侧重于纵向研究，以完善这些管理策略并加强治疗指南，改善有认知能力下降风险患者的总体预后。
