Keywords
Cognitive impairment
Elderly
Brain function
COVID-19
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objective: Investigate the relationship between systemic arterial hypertension (SAH) and cognitive impairment in the elderly, analyzing the effects of cerebral hypoperfusion on neurodegeneration and the impacts of different therapeutic approaches on cognitive function. Literature Review: SAH is a significant risk factor for cardiovascular and neurodegenerative diseases, potentially contributing to neurovascular dysfunction and an increased incidence of vascular dementia and Alzheimer’s disease. Chronic cerebral hypoperfusion may promote the formation of amyloid plaques and neurofibrillary tangles. While evidence suggests that lowering blood pressure may reduce the risk of cognitive impairment, studies also point to a "cardiovascular paradox," where elevated blood pressure may have a protective effect against cognitive decline in the elderly. Treatment adherence, age, and the duration of SAH influence cognitive outcomes. Management of SAH should include neurocognitive monitoring, pharmacological interventions, and lifestyle changes. Final considerations: SAH significantly impacts cognition in the elderly, potentially contributing to neurodegenerative diseases. Longitudinal studies are needed to clarify the relationship between blood pressure control and cognitive function, in order to guide better interventional strategies.
References
ANDERSON ND. State of the science on mild cognitive impairment (MCI). CNS Spectr, 2019; 24(1): 78-87.
ARANDA MP, et al. Impact of Dementia: health disparities, population trends, care interventions, and economic costs. J Am Geriatr Soc, 2021; 69: 1774-1783.
ARONOW WS. Hypertension and cognitive impairment. Annals of Translational Medicine, 2019; 5(12): 259.
ARVANITAKIS Z, et al. Diagnosis and Management of Dementia: Review. JAMA, 2019; 322(22): 1589-1599.
BARROS EMAHA, et al. Comprometimento cognitivo e fatores associados em uma população de idosos. Cadernos Saúde Coletiva, 2023; 31: e31040493.
BARROSO WKS, et al. Diretrizes Brasileiras de Hipertensão Arterial – 2020. Brazilian Guidelines of Hypertension – 2020.
CANAVAN M, O'DONNELL MJ. Hypertension and Cognitive Impairment: A Review of Mechanisms and Key Concepts. Front Neurol, 2022; 4(13).
CHAVES AS, et al. Associação entre declínio cognitivo e qualidade de vida de idosos hipertensos. Rev Bras Geriatr Gerontol, 2019; 18(3): 545-556.
DELORME C, et al. COVID‐19‐related encephalopathy: a case series with brain FDG‐positron‐emission tomography/computed tomography findings. European Journal of Neurology, 2020; 27(12): 2651-2657.
DE SOUSA WP, et al. Relação entre dor crônica e estado cognitivo de pacientes com doenças crônicas não transmissíveis. REVISA, 2024; 13(3): 752-763.
DRUMOND LDS, et al. A Relação entre Idosos Hipertensos e Déficit Cognitivo. Revista Eletrônica Acervo Saúde, 2020; 12: 10, e4593.
FORTE G, et al. Heart Rate Variability and Cognitive Function: A Systematic Review. Front Neurosci, 2019; 9(13): 710.
GOSHGARIAN C, GORELICK PB. Perspectives on the relation of blood pressure and cognition in the elderly. Trends Cardiovasc Med, 2019; 29(1): 12-18.
INTERNATIONAL SOCIETY OF HYPERTENSION. Information and resources related to the 2020 ISH Global Hypertension Practice Guidelines. ISH Global Hypertension Practice Guidelines, 2020.
LAZO-PORRAS M, et al. Cognitive impairment and hypertension in older adults living in extreme poverty: a cross-sectional study in Peru. BMC Geriatrics, 2019; 17(1): 250.
LIU YH, WANG YR, WANG QH, et al. Post-infection cognitive impairments in a cohort of elderly patients with COVID-19. Mol Neurodegeneration, 2021; 16(48).
LIVINGSTON G, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet, 2020; 396(10248): 413-446.
LUZ ALA, et al. Adesão ao tratamento anti-hipertensivo em idosos com comprometimento cognitivo: revisão sistemática. Cogit Enferm, 2021; 26.
LUZ ALA, et al. Função cognitiva e controle da pressão arterial em idosos hipertensos. Ciência & Saúde Coletiva, 2022; 27: 2269-2278.
MARQUES AP, et al. Fatores associados à hipertensão arterial: uma revisão sistemática. Ciênc Saúde Coletiva, 2020; 25(6).
MATOSO JMD, et al. Idosos Hipertensos Apresentam Menor Desempenho Cognitivo do que Idosos Normotensos. Arquivos Brasileiros de Cardiologia, 2023; 100(5): 444-451.
MONTEIRO CA, et al. Vigilância de Fatores de Risco e Proteção Para Doenças Crônicas por Inquérito Telefônico Vigitel. Ministério da Saúde, 2018; 1(1): 13-129.
NICHOLS E, et al. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health, 2022; 7: e105-e125.
PARK SK, et al. Long-term exposure to air pollution and type 2 diabetes mellitus in a multiethnic cohort. American Journal of Epidemiology, 2015; 181(5): 327-336.
PETERSEN RC, et al. Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology, 2018; 90(3): 126-135.
ROBLES NR, MACIAS JF. Hypertension in the elderly. Cardiovasc Hematol Agents Med Chem, 2019; 12(3): 136-145.
SIERRA C, et al. Hypertension and the risk of dementia. Cardiovasc Med Sec Hypertension, 2020; 7: 103-109.
SILVA RC, et al. Anthropometric measures change and incidence of high blood pressure levels among adults: a population-based prospective study in Southern Brazil. J Hypertens, 2020; 35(1): 39-46.
SOARES DB, et al. Relação entre síndrome metabólica e comprometimento cognitivo: uma revisão sistemática, 2021.
SOCIEDADE BRASILEIRA DE CARDIOLOGIA. 7ª Brazilian Guideline of Arterial Hypertension. Arq Bras Cardiol, 2022; 115: 1-83.
UNGVARI Z, et al. Hypertension-induced cognitive impairment: from pathophysiology to public health. Nat Rev Nephrol, 2021; 17(10): 639-654.
VERAS RP. HHS Acesso Público. Clin Cancer Res, 2017; 1-21.
XIA X, WANG Y, ZHENG J. COVID-19 and Alzheimer's disease: how one crisis worsens the other. Transl Neurodegener, 2021; 10(1): 15.