Hypertension and vascular dementia in the elderly: the potential role of anti-hypertensive agents

Abstract

Background:

Vascular dementia (VaD) – a severe form of vascular cognitive impairment – and cognitive decline are associated with hypertension and therefore it seems logical to consider that reducing BP with anti-hypertensive therapy may protect against the development/onset of cognitive function impairment or dementia.

Scope:

This narrative, non-systematic review discusses the available evidence on the potential correlation between the use of anti-hypertensive agents and the risk of VaD and cognitive decline.

Methods:

MEDLINE was searched for inclusion of relevant studies. No limitations in time were considered.

Results:

A consensus on the potential effects of anti-hypertensive treatment in the reduction of VaD and associated cognitive decline has not been reached. A protective effect of anti-hypertensive agents has been observed in a number of studies although it is still unclear whether different classes of anti-hypertensive agents have a different effect on the development of VaD.

Conclusions:

The protective effect of anti-hypertensive agents appears to depend on the specific drug used – positive effects have been observed with calcium channel blockers (CCBs), such as lercanidipine and nitrendipine, the combination perindopril–indapamide and telmisartan.

Keywords::

• Anti-hypertensive agents
• Cognitive decline
• Hypertension
• Vascular dementia, calcium channel blockers

Transparency

Declaration of funding

Editorial assistance for the preparation of this manuscript was provided by Content Ed Net and was supported by Recordati.

Declaration of financial/other relationships

A.C. has received research grants from Abbott and Novartis, served as a consultant for Novartis, Menarini and Recordati, and was in the Speakers Bureau of Abbott, Chiesi, Daichi-Sankyo, Medtronics and Novartis.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgments

Editorial assistance for the preparation of this manuscript was provided by Luca Giacomelli PhD and Ambra Corti on behalf of Content Ed Net; this assistance was funded by Recordati.