REVIEW   

Panminerva Medica 2018 March;60(1):8-16

DOI: 10.23736/S0031-0808.18.03360-8

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

High blood pressure, Alzheimer disease and antihypertensive treatment

Agustí MARFANY, Cristina SIERRA ✉, Miguel CAMAFORT, Mónica DOMÉNECH, Antonio COCA

Unit of Hypertension and Vascular Risk, Department of Internal Medicine, Hospital Clinic of Barcelona (IDIBAPS), University of Barcelona, Barcelona, Spain

Alzheimer’s disease (AD), the most common form of dementia, is a complex disease, the mechanisms of which are poorly understood. AD represents 70% of all dementia cases, affecting up to 50% of elderly persons aged 85 or older, with functional dependence, poor quality of life, institutionalization and mortality. Advanced age is the main risk factor of AD, that is why population ageing, due to life expectancy improvements, increases AD incidence and prevalence, as well as the economic, social, and emotional costs associated with this illness. Existing anti-AD drugs present some limitations, as they target specific downstream neurochemical abnormalities while the upstream underlying pathology continues unchecked. Chronic hypertension has been suggested as one of the largest modifiable risk factors for developing AD. At least 25% of all adults and more than 50% of those over 60 years of age have hypertension. Epidemiological studies have shown that hypertension is a risk factor for dementia and AD, but the association is complex. Some studies have demonstrated that antihypertensive drugs can reduce the risk of AD. This review focuses on current knowledge about the relationship between chronic hypertension and AD as well as antihypertensive treatment effect on AD pathogenesis and its clinical outcomes.

KEY WORDS: Hypertension - Alzheimer disease - Cognitive dysfunction - Cerebral small vessel disease