Hypertension-Induced Cerebral Small Vessel Disease Leading to Cognitive Impairment
Objective: Alzheimer's disease and vascular dementia are responsible for more than 80% of dementia cases. These two conditions share common risk factors including hypertension. Cerebral small vessel disease (CSVD) is strongly associated with both hypertension and cognitive impairment. In this r...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2018-01-01
|
| Series: | Chinese Medical Journal |
| Subjects: | |
| Online Access: | http://www.cmj.org/article.asp?issn=0366-6999;year=2018;volume=131;issue=5;spage=615;epage=619;aulast=Liu |
| _version_ | 1819032982383493120 |
|---|---|
| author | Yang Liu Yan-Hong Dong Pei-Yuan Lyu Wei-Hong Chen Rui Li |
| author_facet | Yang Liu Yan-Hong Dong Pei-Yuan Lyu Wei-Hong Chen Rui Li |
| author_sort | Yang Liu |
| collection | DOAJ |
| description | Objective: Alzheimer's disease and vascular dementia are responsible for more than 80% of dementia cases. These two conditions share common risk factors including hypertension. Cerebral small vessel disease (CSVD) is strongly associated with both hypertension and cognitive impairment. In this review, we identify the pathophysiological changes in CSVD that are caused by hypertension and further explore the relationship between CSVD and cognitive impairment.
Data Sources: We searched and scanned the PubMed database for recently published literatures up to December 2017. We used the keywords of “hypertension”, “cerebral small vessel disease”, “white matter lesions”, “enlarged perivascular spaces”, “lacunar infarcts”, “cerebral microbleeds”, and “cognitive impairment” in the database of PubMed.
Study Selection: Articles were obtained and reviewed to analyze the hypertension-induced pathophysiological changes that occur in CSVD and the correlation between CSVD and cognitive impairment.
Results: In recent years, studies have demonstrated that hypertension-related changes (e.g., small vascular lesions, inflammatory reactions, hypoperfusion, oxidative stress, damage to autoregulatory processes and the blood-brain barrier, and cerebral amyloid angiopathy) can occur over time in cerebral small vessels, potentially leading to lower cognitive function when blood pressure (BP) control is poor or lacking. Both isolated and co-occurrent CSVD can lead to cognitive deterioration, and this effect may be attributable to a dysfunction in either the cholinergic system or the functionality of cortical and subcortical tracts.
Conclusions: We explore the currently available evidence about the hypertensive vasculopathy and inflammatory changes that occur in CSVD. Both are vital prognostic indicators of the development of cognitive impairment. Future studies should be performed to validate the relationship between BP levels and CSVD progression and between the numbers, volumes, and anatomical locations of CSVD and cognitive impairment. |
| first_indexed | 2024-12-21T07:10:35Z |
| format | Article |
| id | doaj.art-c0cf63187db4407fb9dd9374147e76a8 |
| institution | Directory Open Access Journal |
| issn | 0366-6999 |
| language | English |
| last_indexed | 2024-12-21T07:10:35Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Chinese Medical Journal |
| spelling | doaj.art-c0cf63187db4407fb9dd9374147e76a82022-12-21T19:11:59ZengWolters KluwerChinese Medical Journal0366-69992018-01-01131561561910.4103/0366-6999.226069Hypertension-Induced Cerebral Small Vessel Disease Leading to Cognitive ImpairmentYang LiuYan-Hong DongPei-Yuan LyuWei-Hong ChenRui LiObjective: Alzheimer's disease and vascular dementia are responsible for more than 80% of dementia cases. These two conditions share common risk factors including hypertension. Cerebral small vessel disease (CSVD) is strongly associated with both hypertension and cognitive impairment. In this review, we identify the pathophysiological changes in CSVD that are caused by hypertension and further explore the relationship between CSVD and cognitive impairment. Data Sources: We searched and scanned the PubMed database for recently published literatures up to December 2017. We used the keywords of “hypertension”, “cerebral small vessel disease”, “white matter lesions”, “enlarged perivascular spaces”, “lacunar infarcts”, “cerebral microbleeds”, and “cognitive impairment” in the database of PubMed. Study Selection: Articles were obtained and reviewed to analyze the hypertension-induced pathophysiological changes that occur in CSVD and the correlation between CSVD and cognitive impairment. Results: In recent years, studies have demonstrated that hypertension-related changes (e.g., small vascular lesions, inflammatory reactions, hypoperfusion, oxidative stress, damage to autoregulatory processes and the blood-brain barrier, and cerebral amyloid angiopathy) can occur over time in cerebral small vessels, potentially leading to lower cognitive function when blood pressure (BP) control is poor or lacking. Both isolated and co-occurrent CSVD can lead to cognitive deterioration, and this effect may be attributable to a dysfunction in either the cholinergic system or the functionality of cortical and subcortical tracts. Conclusions: We explore the currently available evidence about the hypertensive vasculopathy and inflammatory changes that occur in CSVD. Both are vital prognostic indicators of the development of cognitive impairment. Future studies should be performed to validate the relationship between BP levels and CSVD progression and between the numbers, volumes, and anatomical locations of CSVD and cognitive impairment.http://www.cmj.org/article.asp?issn=0366-6999;year=2018;volume=131;issue=5;spage=615;epage=619;aulast=LiuCerebral Microbleeds; Cerebral Small Vessel Disease; Cognitive Impairment; Hypertension |
| spellingShingle | Yang Liu Yan-Hong Dong Pei-Yuan Lyu Wei-Hong Chen Rui Li Hypertension-Induced Cerebral Small Vessel Disease Leading to Cognitive Impairment Chinese Medical Journal Cerebral Microbleeds; Cerebral Small Vessel Disease; Cognitive Impairment; Hypertension |
| title | Hypertension-Induced Cerebral Small Vessel Disease Leading to Cognitive Impairment |
| title_full | Hypertension-Induced Cerebral Small Vessel Disease Leading to Cognitive Impairment |
| title_fullStr | Hypertension-Induced Cerebral Small Vessel Disease Leading to Cognitive Impairment |
| title_full_unstemmed | Hypertension-Induced Cerebral Small Vessel Disease Leading to Cognitive Impairment |
| title_short | Hypertension-Induced Cerebral Small Vessel Disease Leading to Cognitive Impairment |
| title_sort | hypertension induced cerebral small vessel disease leading to cognitive impairment |
| topic | Cerebral Microbleeds; Cerebral Small Vessel Disease; Cognitive Impairment; Hypertension |
| url | http://www.cmj.org/article.asp?issn=0366-6999;year=2018;volume=131;issue=5;spage=615;epage=619;aulast=Liu |
| work_keys_str_mv | AT yangliu hypertensioninducedcerebralsmallvesseldiseaseleadingtocognitiveimpairment AT yanhongdong hypertensioninducedcerebralsmallvesseldiseaseleadingtocognitiveimpairment AT peiyuanlyu hypertensioninducedcerebralsmallvesseldiseaseleadingtocognitiveimpairment AT weihongchen hypertensioninducedcerebralsmallvesseldiseaseleadingtocognitiveimpairment AT ruili hypertensioninducedcerebralsmallvesseldiseaseleadingtocognitiveimpairment |