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Antihypertensive &cognitive impairment

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https://www.readbyqxmd.com/read/29117962/lower-cardiac-index-levels-relate-to-lower-cerebral-blood-flow-in-older-adults
#1
Angela L Jefferson, Dandan Liu, Deepak K Gupta, Kimberly R Pechman, Jennifer M Watchmaker, Elizabeth A Gordon, Swati Rane, Susan P Bell, Lisa A Mendes, L Taylor Davis, Katherine A Gifford, Timothy J Hohman, Thomas J Wang, Manus J Donahue
OBJECTIVE: To assess cross-sectionally whether lower cardiac index relates to lower resting cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) among older adults. METHODS: Vanderbilt Memory & Aging Project participants free of stroke, dementia, and heart failure were studied (n = 314, age 73 ± 7 years, 59% male, 39% with mild cognitive impairment). Cardiac index (liters per minute per meter squared) was quantified from echocardiography. Resting CBF (milliliters per 100 grams per minute) and hypercapnia-induced CVR were quantified from pseudo-continuous arterial spin-labeling MRI...
November 8, 2017: Neurology
https://www.readbyqxmd.com/read/29111025/orthostatic-hypotension-associated-with-executive-dysfunction-in-mild-cognitive-impairment
#2
Christian Bocti, François Pépin, Maxime Tétreault, Philippe Cossette, Francis Langlois, Hélène Imbeault, Nadia Duval, Guy Lacombe, Tamas Fulop
INTRODUCTION: Midlife hypertension is associated with dementia in longitudinal studies while chronic hypotension in the elderly is associated with dementia onset. Orthostatic hypotension could influence cognitive performance in the elderly. The objective of this study was to assess the relationship between orthostatic hypotension and cognitive functions. METHODS: Consecutive participants with complete neuropsychological evaluation from a Memory Clinic were included...
November 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29094046/association-between-antihypertensive-drug-use-and-the-incidence-of-cognitive-decline-and-dementia-a-meta-analysis-of-prospective-cohort-studies
#3
REVIEW
Guangli Xu, Feng Bai, Xin Lin, Qiongying Wang, Qiang Wu, Shougang Sun, Cheng Jiang, Qiang Liang, Bingren Gao
Background: Antihypertensive drug use is inconsistently associated with the risk of dementia, Alzheimer's disease, cognitive impairment, and cognitive decline. Therefore, we conducted a meta-analysis of available prospective cohort studies to summarize the evidence on the strength of these relationships. Methods: Three electronic databases including MedLine, Embase, and the Cochrane Library were searched to identify studies from inception to April 2017. Only prospective cohort studies that reported effect estimates with corresponding 95% confidence intervals (CIs) of dementia, Alzheimer's disease, cognitive impairment, and cognitive decline for antihypertensive drug use versus not using antihypertensive drugs were included...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28965768/prehypertension-is-real-and-can-be-associated-with-target-organ-damage
#4
REVIEW
Barry J Materson, Manuel Garcia-Estrada, Stephane B Degraff, Richard A Preston
Prehypertension (systolic blood pressure 120-139 or diastolic blood pressure 80-89 mm Hg) confers a risk of progression to hypertension, impairment of cognitive function, increased left ventricular mass, risk of end-stage renal disease, and an association with arteriosclerosis. Recent studies provide data that could support the rationale for treating prehypertensives subjects with antihypertensive medications in addition to lifestyle modification, especially if they have concomitant cardiovascular risk factors...
November 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28958009/masked-hypertension-is-associated-with-cognitive-decline-in-geriatric-age-g-mash-cog-study-geriatric-masked-hypertension-and-cognition
#5
Mert Esme, Burcu Balam Yavuz, Bunyamin Yavuz, Serkan Asil, Rana Tuna Dogrul, Fatih Sumer, Mustafa Kemal Kilic, Muhammet Cemal Kizilarslanoglu, Hacer Dogan Varan, Aykut Sagir, Cafer Balci, Meltem Halil, Mustafa Cankurtaran
Background: Masked hypertension is described as high ambulatory blood pressure measurements (ABPM) where office blood pressure measurements are normal. Effect of hypertension on cognitive functions is well known. However, the effect of masked hypertension on cognitive functions is unclear. The aim of this study is to examine the relationship between masked hypertension and cognitive functions. Methods: One hundred-two normotensive patients admitted to the Geriatric Medicine outpatient clinic were included...
August 8, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28870834/prevalence-of-preventive-cardiovascular-medication-use-in-nursing-home-residents-room-for-deprescribing-the-shelter-study
#6
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
#7
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
#8
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 1903 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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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