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What Is the Relation Between Hypertension and Dementia?

As progress is made in the prevention and treatment of dementia, early detection becomes more important. This study was undertaken to determine whether early predictors of cognitive impairment could be identified. The initial 1083 subjects (mean age, 70.2) were enrolled in a British hypertension treatment trial in 1983-84 and then contacted 9 to 12 years later. Of the survivors, 58.6 percent (387) participated in the full follow-up; 66 percent were female. Cognitive function was assessed using the Mini-Mental State Examination (MMSE).

After correcting for baseline cognition, the state of cognition at follow-up was negatively correlated with increasing age, less decline in systolic blood pressure, family history of dementia, abstinence from alcohol, and lower premorbid IQ.

Comment: Although the MMSE is a rather gross measure of cognitive status, these findings reinforce what we know: People who are older, don't control their hypertension, and come from families with a history of dementia are more likely to experience cognitive decline than older people without these risk factors. This is an important article because it helps clinicians to focus on treatable causes of dementia. Neither clinicians nor patients can affect family history or growing older, but this study provides further support for clinicians to convince patients to adhere to antihypertensive treatments and, when appropriate, to discuss the possible benefits of moderate alcohol consumption.

— NL Stotland

Published in Journal Watch Women's Health August 7, 2000

Citation(s):

Cervilla JA et al. Long-term predictors of cognitive outcome in a cohort of older people with hypertension. Br J Psychiatry 2000 Jul 177 66-71.

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