In the prevention of dementia, the focus should be on early and consistent treatment of hypertension

Czech version

Authors: Miroslav Souček
Authors‘ workplace: II. interní klinika FN u sv. Anny v Brně
Published in: Vnitř Lék 2023; 69(4): 249-253
Category: Review Articles
doi: https://doi.org/10.36290/vnl.2023.047

Overview

The brain is among the target organs of hypertension. Patients with hypertension have a higher risk of developing stroke as well as experiencing a decline in cognitive functions and dementia. Changes in the white matter and atrophy of the grey matter of the brain induced by high blood pressure develop insidiously since the onset of hypertension, even in young individuals. The effect of high blood pressure on the vessel wall cumulates in time; therefore, hypertension in younger people implies an increased risk of dementia in older age. Hypertension in young age cannot be considered a benign condition. Hypertension in middle age increases the risk of dementia by 61 %. Consistent and early hypertension control can reverse the adverse development towards dementia and lack of self-sufficiency in the patient. Data comparing individual antihypertensive drugs in terms of preventing dementia are scarce. However, renin angiotensin system blockers have been found to protect against Alzheimer’s disease more than other classes of antihypertensive drugs. To achieve rapid and effective hypertension control, a combination of antihypertensive drugs is usually required. Using a fixed-dose triple combination of perindopril, indapamide, and amlodipine, blood pressure targets of < 130/80 mm Hg can be achieved within three months in 93 % of patients.

Keywords:

dementia – hypertension – cognitive function – hypertension-induced end-organ damage – RAS inhibitors – ACEI – sartans – fixed-dose triple combination of antihypertensive drugs – Triplixam

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