Antihypertensives, Angiotensin, and Alzheimer's Disease
Antihypertensives, Angiotensin, and Alzheimer's Disease
Research into AD, its progression and its causes, is becoming increasingly complex and multifactorial. It can be seen that hypertension and related vascular disorders are detrimental to cognitive health if they are experienced in midlife due to blood vessel damage. However, the influence of hypertension may not be as straight forward as people aging. Indeed, mild hypertension has been observed to be beneficial for cognition in the oldest elderly patients. Therefore the relationship between different blood pressure levels at different ages needs to be addressed as this may provide treatment possibilities for hypertension in relation to cognition, especially in later life. This may be looked at using epidemiological studies, which are able to longitudinally follow many participants to measure age-related changes within a population. The findings from such studies can be used to create prediction models. So far, although there have been very large longitudinal studies on vascular health, the mix of cognitive testing, end points and medication used have made them difficult to compare. More biological and epidemiological studies are still needed to assess potential differences between midlife hypertension and hypertension developing in later life. An ongoing study will try to shed further light on this as retrospective data on hypertension and its treatment from surgeries will be gathered from patients attending a memory clinic. Cognition, cerebrovascular lesional load and so on between those who have had hypertension for many years and those who have developed it recently will be compared.
Expert Commentary
Research into AD, its progression and its causes, is becoming increasingly complex and multifactorial. It can be seen that hypertension and related vascular disorders are detrimental to cognitive health if they are experienced in midlife due to blood vessel damage. However, the influence of hypertension may not be as straight forward as people aging. Indeed, mild hypertension has been observed to be beneficial for cognition in the oldest elderly patients. Therefore the relationship between different blood pressure levels at different ages needs to be addressed as this may provide treatment possibilities for hypertension in relation to cognition, especially in later life. This may be looked at using epidemiological studies, which are able to longitudinally follow many participants to measure age-related changes within a population. The findings from such studies can be used to create prediction models. So far, although there have been very large longitudinal studies on vascular health, the mix of cognitive testing, end points and medication used have made them difficult to compare. More biological and epidemiological studies are still needed to assess potential differences between midlife hypertension and hypertension developing in later life. An ongoing study will try to shed further light on this as retrospective data on hypertension and its treatment from surgeries will be gathered from patients attending a memory clinic. Cognition, cerebrovascular lesional load and so on between those who have had hypertension for many years and those who have developed it recently will be compared.
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