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High blood pressure in dementia: How low can we go?

Authors
 Yuda Turana  ;  Jeslyn Tengkawan  ;  Yook-Chin Chia  ;  Boon Wee Teo  ;  Jinho Shin  ;  Guru Prasad Sogunuru  ;  Arieska Ann Soenarta  ;  Huynh Van Minh  ;  Peera Buranakitjaroen  ;  Chen-Huan Chen  ;  Jennifer Nailes  ;  Satoshi Hoshide  ;  Sungha Park  ;  Saulat Siddique  ;  Jorge Sison  ;  Apichard Sukonthasarn  ;  Jam Chin Tay  ;  Tzung-Dau Wang  ;  Narsingh Verma  ;  Yu-Qing Zhang  ;  Ji-Guang Wang  ;  Kazuomi Kario 
Citation
 JOURNAL OF CLINICAL HYPERTENSION, Vol.22(3) : 415-422, 2020-03 
Journal Title
JOURNAL OF CLINICAL HYPERTENSION
ISSN
 1524-6175 
Issue Date
2020-03
MeSH
Aged ; Aged, 80 and over ; Angiotensin Receptor Antagonists / therapeutic use ; Angiotensin-Converting Enzyme Inhibitors / therapeutic use ; Antihypertensive Agents / pharmacology* ; Antihypertensive Agents / therapeutic use ; Asia ; Blood Pressure / drug effects ; Calcium Channel Blockers / therapeutic use ; Cross-Sectional Studies ; Dementia* / epidemiology ; Drug Therapy, Combination ; Humans ; Hypertension* / drug therapy ; Hypertension* / epidemiology
Keywords
Asia ; cognitive dysfunction ; dementia ; hypertension ; oldest old
Abstract
Hypertension is an important public health concern. The prevalence keeps increasing, and it is a risk factor for several adverse health outcomes including a decline in cognitive function. Recent data also show that the prevalence of hypertension and age-related dementia is rising in Asian countries, including in the oldest old group. This study aims to discuss possible treatments for high blood pressure in the elderly and propose an optimal target for BP relative to cognitive outcomes. This review discusses several studies on related blood pressure treatments that remain controversial and the consequences if the treatment target is too low or aggressive. Longitudinal, cross-sectional, and RCT studies were included in this review. An optimum systolic blood pressure of 120-130 mm Hg is recommended, especially in nondiabetic hypertensive patients with significant risk factors. In the oldest old group of patients, hypertension might have a protective effect. The use of calcium channel blockers (CCB) and angiotensin receptor blocker (ARB) is independently associated with a decreased risk of dementia in older people. However, personalized care for patients with hypertension, especially for patients who are frail or very old, is encouraged.
Files in This Item:
T9992020409.pdf Download
DOI
10.1111/jch.13752
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190184
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