Prevention of dementia and cerebroprotection with antihypertensive drugs |
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Authors: | Olivier Hanon Marie Laure Seux Hermine Lenoir Anne Sophie Rigaud Françoise Forette |
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Institution: | 1.H?pital Broca, CHU Cochin Port-Royal,Université René Descartes,Paris,France |
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Abstract: | High blood pressure is a major risk factor for stroke and is also closely correlated with cognitive decline and dementia.
Indeed, most longitudinal studies showed that cognitive functioning is often inversely proportional to blood pressure values
measured 15 or 20 years previously. Because of the aging of the population, the frequency of stroke and dementia will dramatically
increase in the coming years. Therefore, the prevention of cerebrovascular and cognitive disorders represents a major challenge.
Antihypertensive drugs have shown clinical benefits in both primary and secondary prevention of strokes. Consensus is generally
that blood-pressure lowering represents the major determinant of the benefit conferred by the antihypertensive treatment for
stroke prevention; however, recent studies have suggested some differences between classes of antihypertensive drugs. The
results of therapeutic trials (Systolic Hypertension in Europe Syst-Eur], Perindopril Protection Against Recurrent Stroke
Study PROGRESS]) open the way to the prevention of dementia (vascular or Alzheimer’s type) by antihypertensive treatments.
These two studies suggest different mechanisms for the prevention of cognitive decline using antihypertensive drugs. In this
context, reduced incidence of dementia should be the primary outcome of future trials comparing different classes of antihypertensive
drugs. |
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