Tag Archives: Hypertension

High blood pressure and dementia

9 Nov

A paper published in the journal Hypertension, here is the abstract:

Background—Age-related dementia, most commonly caused by Alzheimer disease or cerebrovascular factors (vascular dementia), is a major public health threat. Chronic arterial hypertension is a well-established risk factor for both types of dementia, but the link between hypertension and its treatment and cognition remains poorly understood. In this scientific statement, a multidisciplinary team of experts examines the impact of hypertension on cognition to assess the state of the knowledge, to identify gaps, and to provide future directions.

Methods—Authors with relevant expertise were selected to contribute to this statement in accordance with the American Heart Association conflict-of-interest management policy. Panel members were assigned topics relevant to their areas of expertise, reviewed the literature, and summarized the available data.

Results—Hypertension disrupts the structure and function of cerebral blood vessels, leads to ischemic damage of white matter regions critical for cognitive function, and may promote Alzheimer pathology. There is strong evidence of a deleterious influence of midlife hypertension on late-life cognitive function, but the cognitive impact of late-life hypertension is less clear. Observational studies demonstrated a cumulative effect of hypertension on cerebrovascular damage, but evidence from clinical trials that antihypertensive treatment improves cognition is not conclusive.

Conclusions—After carefully reviewing the literature, the group concluded that there were insufficient data to make evidence-based recommendations. However, judicious treatment of hypertension, taking into account goals of care and individual characteristics (eg, age and comorbidities), seems justified to safeguard vascular health and, as a consequence, brain health.

The ultimate quantified self

13 Jan

A story in Vox about 69 year old chronobiologist Robert Sothern’s daily recording of his own vital signs. Something he has been doing for decades:

“I measure my heart rate for a minute,” he tells me on a recent phone call. “I measure blood pressure. I measure respiration for two minutes, breathing slowly and counting how many times I inhale. I measure peak flow [air flow from the lungs], and I’m doing time estimation [counting to 60 without looking at the clock, and then seeing if it matches].” Fourteen years ago, he started to wear a step tracker.

Sothern notes the appearance of cycles in his data:

“We are rhythmic creatures,” Sothern, says. “You look at this … data [and] you can see 10-year cycles in it. You can see daily cycles. You can see even men have something approaching a 28-day cycle in their beard growth — which I did measure for three years too. By having a rhythm, it proves that you are alive.”

Check out Goolge Scholar to see some of his reasearch

Study: ACE inhibitors may slow cognitive decline in dementia

28 Jul

ACE inhibitors are drugs primarily used to treat high blood pressure. Some ACE inhibitors are classified as centrally acting because they cross the blood brain barrier.

Now a study published in the British Medical Journal suggests that centrally acting ACE inhibitors might slow cognitive decline in patients with dementia. Scores on standard tests of cognitive impairment such as the Mini–mental state examination were stable after six months for patients who used the centrally acting ACE inhibitors when confounding variables (such as blood pressure and years of education) were controlled.

The researchers was careful to report limitations of their study. These are the kind of details that often are missed in popular accounts of scientific research. For example, the authors state:

“the differences were small and of uncertain clinical significance”

In addition, the study was based on the examination of an existing data base and not every patient in the data base was tested at both baseline and six months. Thus, the necessary exclusion of these patients may have introduced a bias into the study that could not be properly controlled. Randomized prospective research will be needed to confirm or falsify these results.

Beware of anyone who tries to market these drugs for dementia before additional research is conducted.

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