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Antihypertensive &cognitive impairment

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https://www.readbyqxmd.com/read/28870834/prevalence-of-preventive-cardiovascular-medication-use-in-nursing-home-residents-room-for-deprescribing-the-shelter-study
#1
Alireza Malek Makan, Hein van Hout, Graziano Onder, Harriet Finne-Soveri, Henriëtte van der Roest, Rob van Marum
INTRODUCTION: In nursing home (NH) residents with a very short life expectancy, the benefits of preventive cardiovascular medication maintenance are questionable. OBJECTIVE: To assess the prevalence of 4 classes of preventive cardiovascular medication (PCM) in NH residents, and to explore differences of prevalence across length of stay, mortality risk, cognitive impairment, functional disability, and across countries. METHODS: A 12-month prospective cohort study was conducted in 57 NHs in 8 countries (Czech Republic, England, Finland, France, Germany, Italy, The Netherlands, and Israel)...
September 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28870545/arterial-stiffness-and-cognitive-impairment
#2
REVIEW
Xiaoxuan Li, Peiyuan Lyu, Yanyan Ren, Jin An, Yanhong Dong
BACKGROUND: Arterial stiffness is one of the earliest indicators of changes in vascular wall structure and function and may be assessed using various indicators, such as pulse-wave velocity (PWV), the cardio-ankle vascular index (CAVI), the ankle-brachial index (ABI), pulse pressure (PP), the augmentation index (AI), flow-mediated dilation (FMD), carotid intima media thickness (IMT) and arterial stiffness index-β. Arterial stiffness is generally considered an independent predictor of cardiovascular and cerebrovascular diseases...
September 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28836733/cognitive-impairment-and-cardiovascular-medication-use-results-from-wave-1-of-the-irish-longitudinal-study-on-ageing
#3
Daniela Rohde, Anne Hickey, David Williams, Kathleen Bennett
AIM: To explore the association between cardiovascular medication use and cognitive impairment in adults aged 50 years and over. METHOD: This cross-sectional linked database study involved secondary quantitative analysis of 1,903 participants from wave 1 of the Irish Longitudinal Study on Ageing with available pharmacy claims data. Cognitive impairment was assessed using a cut-off of ≤23 on the Montreal Cognitive Assessment. Cardiovascular medication use was calculated using the proportion of days covered for antihypertensive, antithrombotic, and lipid-modifying medications...
August 24, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28733707/angiotensin-ii-type-1-receptor-blockers-inhibit-kat-ii-activity-in-the-brain-its-possible-clinical-applications
#4
Izabela Zakrocka, Katarzyna M Targowska-Duda, Artur Wnorowski, Tomasz Kocki, Krzysztof Jóźwiak, Waldemar A Turski
Angiotensin II receptor blockers (ARBs) are one of the most frequently recommended antihypertensive drugs. Apart from their activity towards the circulatory system, ARBs also penetrate the blood-brain barrier and display neuroprotective effects. Kynurenic acid (KYNA) is an endogenous metabolite of tryptophan produced by kynurenine aminotransferase II (KAT II) in the brain. Antagonism towards all ionotropic glutamate (GLU) receptors is the main mechanism of KYNA action. An elevated brain level of KYNA is linked with memory impairment and psychotic symptoms...
July 21, 2017: Neurotoxicity Research
https://www.readbyqxmd.com/read/28731439/antihypertensive-treatment-is-associated-with-mri-derived-markers-of-neurodegeneration-and-impaired-cognition-a-propensity-weighted-cohort-study
#5
Jodi D Edwards, Joel Ramirez, Brandy L Callahan, Sheldon W Tobe, Paul Oh, Courtney Berezuk, Krista Lanctôt, Walter Swardfager, Sean Nestor, Alexander Kiss, Stephen Strother, Sandra E Black
BACKGROUND: Hypertension is an important risk factor for Alzheimer's disease (AD) and cerebral small vessel disease. Angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are common anti-hypertensive treatments, but have differential effects on cortical amyloid. OBJECTIVE: The objective of this study was to evaluate associations between anti-hypertensive treatment, brain volume, and cognition, using a propensity-weighted analysis to account for confounding by indication...
2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28652459/blood-pressure-antihypertensive-polypharmacy-frailty-and-risk-for-serious-fall-injuries-among-older-treated-adults-with-hypertension
#6
Samantha G Bromfield, Cedric-Anthony Ngameni, Lisandro D Colantonio, C Barrett Bowling, Daichi Shimbo, Kristi Reynolds, Monika M Safford, Maciej Banach, Peter P Toth, Paul Muntner
Antihypertensive medication and low systolic blood pressure (BP) and diastolic BP have been associated with an increased falls risk in some studies. Many older adults have indicators of frailty, which may increase their risk for falls. We contrasted the association of systolic BP, diastolic BP, number of antihypertensive medication classes taken, and indicators of frailty with risk for serious fall injuries among 5236 REGARDS study (Reasons for Geographic and Racial Difference in Stroke) participants ≥65 years taking antihypertensive medication at baseline with Medicare fee-for-service coverage...
August 2017: Hypertension
https://www.readbyqxmd.com/read/28605058/cardiovascular-pharmacogenomics-and-cognitive-function-in-patients-with-schizophrenia
#7
Kristen M Ward, A Zarina Kraal, Stephanie A Flowers, Vicki L Ellingrod
The authors sought to examine the impact of multiple risk alleles for cognitive dysfunction and cardiovascular disease risk on cognitive function and to determine if these relationships varied by cognitive reserve (CR) or concomitant medication use in patients with schizophrenia. They conducted a cross-sectional study in ambulatory mental health centers. A total of 122 adults with a schizophrenia spectrum diagnosis who were maintained on a stable antipsychotic regimen for at least 6 months before study enrollment were included...
September 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28532183/treatment-options-and-considerations-for-hypertensive-patients-to-prevent-dementia
#8
REVIEW
Intza Hernandorena, Emmanuelle Duron, Jean-Sébastien Vidal, Olivier Hanon
Dementia is a worldwide health concern, which leads to loss of autonomy. To date no curative treatment is available so focus on modifiable risk factors is of particular interest. Hypertension, particularly midlife high blood pressure, has been associated with an increased risk for cognitive decline and dementia including vascular dementia (VAD) and Alzheimer disease (AD). In this context, antihypertensive treatments might have a preventive effect. The objective of this review was to examine the relationship between antihypertensive therapy and cognitive decline or dementia...
July 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28507470/evaluating-the-relationship-of-blood-pressure-plasma-angiotensin-peptides-and-aldosterone-with-cognitive-functions-in-patients-with-hypertension
#9
Selçuk Sen, Nermin Gürel, Baran Ufuktepe, Zeynep Günes Özünal, Çagla Büyüklü, Yagiz Üresin
Renin Angiotensin Aldosterone System (RAAS) plays an important role in the development of hypertension. On the other hand, hypertension is a well-known and independent risk factor for cognitive impairment. The aim of the present study was to evaluate the relationship of blood pressure control, plasma angiotensin peptides and aldosterone with cognitive functions. Forty-one patients who were under treatment with the same antihypertensive medications for at least three months were included in the study. Plasma angiotensin II, angiotensin 1-7, angiotensin IV, and aldosterone concentrations were analyzed using an enzyme-linked immunosorbent assay (ELISA)...
2017: EXCLI journal
https://www.readbyqxmd.com/read/28449585/elevated-plasma-a%C3%AE-42-in-cognitively-impaired-individuals-taking-ace-inhibitor-antihypertensives
#10
William T Regenold, Jacob B Blumenthal, David J Loreck, Kristen L Mordecai, Gina Scarinzi, Seshagiri R Doddi, Lawrence Adler
BACKGROUND/RATIONALE: Accumulating evidence suggests that the use of angiotensin-converting enzyme inhibitor (ACE-I) medication protects against cognitive decline in the elderly patients. We investigated whether ACE-I use was associated with higher plasma levels of amyloid-β (Aβ), possibly indicating improved Aβ clearance from brain to blood. METHODS: We measured and compared plasma concentrations of Aβ42, Aβ40, and creatinine in cognitively impaired individuals with amnestic mild cognitive impairment, probable Alzheimer's disease (AD) dementia, and mixed probable AD/vascular dementia...
September 2017: American Journal of Alzheimer's Disease and Other Dementias
https://www.readbyqxmd.com/read/28439398/a-practical-approach-to-the-pharmacological-management-of-hypertension-in-older-people
#11
REVIEW
Nikesh Parekh, Amy Page, Khalid Ali, Kevin Davies, Chakravarthi Rajkumar
Hypertension is the leading cause of cardiovascular (CV) morbidity and mortality in adults over the age of 65. The first part of this paper is an overview, summarizing the current guidelines on the pharmacological management of hypertension in older adults in Europe and the USA, and evidence from key trials that contributed to the guidelines. In the second part of the paper, we will discuss the major challenges of managing hypertension in the context of multimorbidity, including frailty, orthostatic hypotension (OH), falls and cognitive impairment that are associated with ageing...
April 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28077386/hypertension-severity-is-associated-with-impaired-cognitive-performance
#12
Henrique C S Muela, Valeria A Costa-Hong, Mônica S Yassuda, Natália C Moraes, Claudia M Memória, Michel F Machado, Thiago A Macedo, Edson B S Shu, Ayrton R Massaro, Ricardo Nitrini, Alfredo J Mansur, Luiz A Bortolotto
BACKGROUND: Most evidence of target-organ damage in hypertension (HTN) is related to the kidneys and heart. Cerebrovascular and cognitive impairment are less well studied. Therefore, this study analyzed changes in cognitive function in patients with different stages of hypertension compared to nonhypertensive controls. METHODS AND RESULTS: In a cross-sectional study, 221 (71 normotensive and 150 hypertensive) patients were compared. Patients with hypertension were divided into 2 stages according to blood pressure (BP) levels or medication use (HTN-1: BP, 140-159/90-99 or use of 1 or 2 antihypertensive drugs; HTN-2: BP, ≥160/100 or use of ≥3 drugs)...
January 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28043897/natural-products-against-alzheimer-s-disease-pharmaco-therapeutics-and-biotechnological-interventions
#13
REVIEW
Abhijit Dey, Raktim Bhattacharya, Anuradha Mukherjee, Devendra Kumar Pandey
Alzheimer's disease (AD) is a severe, chronic and progressive neurodegenerative disease associated with memory and cognition impairment ultimately leading to death. It is the commonest reason of dementia in elderly populations mostly affecting beyond the age of 65. The pathogenesis is indicated by accumulation of the amyloid-beta (Aβ) plaques and neurofibrillary tangles (NFT) in brain tissues and hyperphosphorylation of tau protein in neurons. The main cause is considered to be the formation of reactive oxygen species (ROS) due to oxidative stress...
March 2017: Biotechnology Advances
https://www.readbyqxmd.com/read/27809779/hypertension-and-cognitive-dysfunction-in-elderly-blood-pressure-management-for-this-global-burden
#14
REVIEW
Marijana Tadic, Cesare Cuspidi, Dagmara Hering
Arterial hypertension and stroke are strong independent risk factors for the development of cognitive impairment and dementia. Persistently elevated blood pressure (BP) is known to impair cognitive function, however onset of new cognitive decline is common following a large and multiple mini strokes. Among various forms of dementia the most prevalent include Alzheimer's disease (AD) and vascular dementia (VaD) which often present with similar clinical symptoms and challenging diagnosis. While hypertension is the most important modifiable vascular risk factor with antihypertensive therapy reducing the risk of stroke and potentially slowing cognitive decline, optimal BP levels for maintaining an ideal age-related mental performance are yet to be established...
November 3, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27802359/antihypertensive-withdrawal-for-the-prevention-of-cognitive-decline
#15
REVIEW
Susan Jongstra, Jennifer K Harrison, Terry J Quinn, Edo Richard
BACKGROUND: Clinical trials and observational data have variously shown a protective, harmful or neutral effect of antihypertensives on cognitive function. In theory, withdrawal of antihypertensives could improve cerebral perfusion and reduce or delay cognitive decline. However, it is also plausible that withdrawal of antihypertensives may have a detrimental effect on cognition through increased incidence of stroke or other vascular events. OBJECTIVES: To assess the effects of complete withdrawal of at least one antihypertensive medication on incidence of dementia, cognitive function, blood pressure and other safety outcomes in cognitively intact and cognitive impaired adults...
November 1, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27757933/treating-hypertension-to-prevent-cognitive-decline-and-dementia-re-opening-the-debate
#16
M Florencia Iulita, Hélène Girouard
Hypertension and dementia are two of the most prevalent and damaging diseases associated with aging. Chronic hypertension, particularly during mid-life, is a strong risk factor for late-life cognitive decline and impairment. Hypertension is also the number one risk factor for stroke and a major contributor to the pathogenesis of vascular dementia and Alzheimer's disease. Despite the vast epidemiologic and mechanistic evidence linking hypertension to cognitive impairment, and the positive effects of blood pressure lowering on reducing the risk of post-stroke dementia, uncertainty remains about the benefit of antihypertensive medication on other forms of dementia...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27754167/sy-12-3-are-ras-inhibitors-necessary-for-all-patients-with-diabetes-and-chronic-kidney-disease
#17
Shokei Kim-Mitsuyama
There is accumulating evidence that RAS inhibitors not only reduce blood pressure, but also exert pleiotropic effects, including a renoprotective effect, amelioration of insulin resistance, reduction in onset of diabetes, and suppression of cardiovascular remodelling,. However, the definite benefit of RAS inhibition in treatment of hypertension with CKD or DM is not conclusive. We previously performed the OlmeSartan and Calcium Antagonists Randomized (OSCAR) study comparing the preventive effect of high-dose ARB therapy versus ARB plus CCB combination therapy on cardiovascular morbidity and mortality in 1164 Japanese elderly hypertensive patients with baseline type 2 diabetes and/or CVD (Am J Med (2012))...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753800/ssa-01-3-elderly-hypertension-not-the-chronology-but-the-pathophysiology
#18
Katsuhiko Kohara
The effectiveness of antihypertensive treatment in elderly hypertensive patients has been established through numerous randomized clinical trials including the Hypertension in the Very Elderly Trial (HYVET). However, because of the diversity of biological aging among individuals, chronological age is not the sole determinant for the target blood pressure (BP) level at which antihypertensive medications are aimed. Several conditions, especially frailty, needed be evaluated in managing hypertension among elderly people...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27727284/orthostatic-hypotension-and-the-long-term-risk-of-dementia-a-population-based-study
#19
Frank J Wolters, Francesco U S Mattace-Raso, Peter J Koudstaal, Albert Hofman, M Arfan Ikram
BACKGROUND: Orthostatic hypotension (OH) is a common cause of transient cerebral hypoperfusion in the population. Cerebral hypoperfusion is widely implicated in cognitive impairment, but whether OH contributes to cognitive decline and dementia is uncertain. We aimed to determine the association between OH and the risk of developing dementia in the general population. METHODS AND FINDINGS: Between 4 October 1989 and 17 June 1993, we assessed OH in non-demented, stroke-free participants of the population-based Rotterdam Study...
October 2016: PLoS Medicine
https://www.readbyqxmd.com/read/27643122/sy-12-3-are-ras-inhibitors-necessary-for-all-patients-with-diabetes-and-chronic-kidney-disease
#20
Shokei Kim-Mitsuyama
There is accumulating evidence that RAS inhibitors not only reduce blood pressure, but also exert pleiotropic effects, including a renoprotective effect, amelioration of insulin resistance, reduction in onset of diabetes, and suppression of cardiovascular remodelling,. However, the definite benefit of RAS inhibition in treatment of hypertension with CKD or DM is not conclusive. We previously performed the OlmeSartan and Calcium Antagonists Randomized (OSCAR) study comparing the preventive effect of high-dose ARB therapy versus ARB plus CCB combination therapy on cardiovascular morbidity and mortality in 1164 Japanese elderly hypertensive patients with baseline type 2 diabetes and/or CVD (Am J Med (2012))...
September 2016: Journal of Hypertension
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