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Therapeutic Advances in Neurological Disorders
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Review: Blood pressure and dementia — a comprehensive review

Sean P. Kennelly

St James Hospital, Dublin, Ireland, skennelly1976{at}hotmail.com

Brian A. Lawlor

Department of Old Age Psychiatry, Trinity College Dublin, Dublin, Ireland

Rose Anne Kenny

Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland

Alzheimer's disease (AD) and vascular dementia (VaD) are important causes of cognitive decline in the elderly. As a result of an ageing population worldwide, the incidence of dementia is expected to rise exponentially over the coming decades. Vascular risk factors are implicated in the pathogenesis of both AD and VaD. Hypertension in midlife is particularly associated with an increased risk of developing dementia. One might hope the treatment of high blood pressure in midlife would reduce the risk of developing dementia, as it does the risk of stroke. Divergent results have been reported in studies examining this effect, with the evidence suggesting that certain antihypertensives confer benefits beyond others. This implies that certain drugs may have neuroprotective properties separate to their blood pressure lowering capabilities. Recent trials have added to our understanding of these relationships.

Key Words: hypertension • blood pressure • dementia • amyloid • cognitive decline • Alzheimer's • antihypertensive • hypotension

This version was published on July 1, 2009

Therapeutic Advances in Neurological Disorders, Vol. 2, No. 4, 241-260 (2009)
DOI: 10.1177/1756285609103483
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