Among Patients with Chronic Hypertension, Does Blood Pressure Control with Anti-Hypertensives Decrease the Incidence of Cognitive Decline and Vascular dementia

Background: Hypertension (HTN) is a globally prevalent disease that affects nearly 1 billion individuals worldwide.1 Preventing multiorgan failure and vascular risk factors serves as the catalyst for both current research and indication for mainstay treatments of chronic HTN. Studies suggest that non-neurodegenerative dementias such as Vascular dementia—any dementia that is primarily caused by cerebrovascular disease—may be reversible, or progression can be slowed or halted if the underlying cause can be identified early on and adequately treated.2,3 Understanding the mechanism by which chronic high blood pressure affects cognitive function is necessary in order to consider possible interventions such as neuroprotective measures by way of early use of anti-hypertensive medications. The question and primary focus of this literature review was: would early interventions and blood pressure management decrease the risk of Vascular dementia in hypertensive patients? Conclusion: Limited clinical trials have only hinted at potential mechanisms by which the use of antihypertensive medications may provide neuroprotective benefits in preventing cognitive impairment and Vascular dementia. Comorbidities and underlying pathologies still pose barriers to establishing a definitive mechanism. Based upon the literature reviewed and gaps identified, future research necessitates a clearer focus on the neuroprotective effects of specific antihypertensive medication classes, as well as utilizing consistent definitions and screening methods for hypertension and cognitive impairment/dementia