Orthostatic hypotension as a modifiable risk factor for cognitive impairment: a literature review
https://doi.org/10.14412/2074-2711-2019-1-109-116
Abstract
Age-related diseases are becoming an important public health problem due to the rise in the number of elderly and senile people around the world. In this age group, the prevalence of cognitive impairment (CI) no dementia and dementia is great, which determines a significant deterioration in quality of life. Orthostatic hypotension (OH) that is also often detectable at elderly and senile ages is one of the possible risk factors for CI and dementia. The paper reviews publications a relationship between OH and risk for CI/dementia in patients from older age group. Although the results of studies are contradictory, a number of studies and meta-analysis indicate a relationship between OH and CI/dementia in elderly and senile patients. Timely diagnosis of OH will be able not only to identify groups at risk for CI and/or dementia, but also to implement preventive measures in time to reduce this risk.
About the Authors
O. D. Ostroumova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia;
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
Olga Dmitrievna Ostroumova
Department of Clinical Pharmacology and Internal Diseases Propedeutics, Faculty of General Medicine.
SD «Russian Gerontological Scientific-Clinical Center»
8, Trubetskaya St., Build. 2, Moscow,
119991; 216, 1st Leonova St., Moscow 129226
E. V. Shikh
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
Russian Federation
Department of Clinical Pharmacology and Internal Diseases Propedeutics, Faculty of General Medicine
8, Trubetskaya St., Build. 2, Moscow
E. V. Rebrova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
Russian Federation
Department of Clinical Pharmacology and Internal Diseases Propedeutics, Faculty of General Medicine
8, Trubetskaya St., Build. 2, Moscow
A. Yu. Ryazanova
Volgograd State Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
Department of Clinical Pharmacology and Intensive Therapy with Course of Clinical Pharmacology, Faculty for Postgraduate Training of Physicians, and Department of Clinical Allergology, Faculty for Postgraduate Training of Physicians
1, Pavshikh Bortsov Sq.,Volgograd 400131
References
1. Mavrodaris A, Powell J, Thorogood M. Prevalences of dementia and cognitive impairment among older people in sub-Saharan Africa: a systematic review. Bull World Health Organ. 2013 Oct 1;91(10):773-83. doi: 10.2471/BLT.13.118422.
2. Yakhno NN, Zakharov VV, Lokshina AB. Memory and attention disorders in the elderly. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2006;106(2):58-62. (In Russ.).
3. Harada CN, Natelson Love MC, Triebel KL. Normal cognitive aging. Clin Geriatr Med. 2013 Nov;29(4):737-52. doi: 10.1016/j.cger.2013.07.002.
4. Satizabal CL, Beiser AS, Chouraki V, et al. Incidence of dementia over three decades in the Framingham heart study. N Engl J Med. 2016 Feb 11;374(6):523-32. doi: 10.1056/NEJMoa1504327.
5. The global burden of disease: 2004 update. Geneva: World Health Organization; 2008.
6. Zakharov VV. Cognitive disorders without dementia: classification, underlying causes and treatment. Effektivnaya farmakoterapiya. Nevrologiya. 2016;(1):22-30. (In Russ.).
7. Ward A, Arrighi HM, Michels S, Cedarbaum JM. Mild cognitive impairment: disparity of incidence and prevalence estimates. Alzheimers Dement. 2012 Jan;8(1):14-21. doi: 10.1016/j.jalz.2011.01.002.
8. Christensen H, Korten AE, Jorm AF, et al. Education and decline in Cognitive Performance: Compensatory But Not Protective International. Int J Geriatr Psychiatry. 1997 Mar;12(3):323-30.
9. Rawlings AM, Juraschek SP, Heiss G, et al. Association of orthostatic hypotension with incident dementia, stroke, and cognitive decline. Neurology. 2018 Aug 21;91(8):e759- e768. doi: 10.1212/WNL.0000000000006027. Epub 2018 Jul 25.
10. Hebert LE, Weuve J, Scherr PA, Evans DA. Alzheimer disease in the United States (2010- 2050) estimated using the 2010 census. Neurology. 2013 May 7;80(19):1778-83. doi: 10.1212/WNL.0b013e31828726f5. Epub 2013 Feb 6.
11. Sahathevan R, Brodtmann A, Donnan GA. Dementia, stroke, and vascular risk factors: a review. Int J Stroke. 2012 Jan;7(1):61-73. doi: 10.1111/j.1747-4949.2011.00731.x.
12. Kovacic JC, Castellano JM, Fuster V. The links between complex coronary disease, cerebrovascular disease, and degenerative brain disease. Ann N Y Acad Sci. 2012 Apr;1254:99- 105. doi: 10.1111/j.1749-6632.2012.06482.x.
13. Santos CY, Snyder PJ, Wu WC, et al. Pathophysiologic relationship between Alzheimer's disease, cerebrovascular disease, and cardiovascular risk: a review and synthesis. Alzheimers Dement (Amst). 2017 Feb 9;7:69-87. doi: 10.1016/j.dadm.2017.01.005. eCollection 2017.
14. Ricci F, Fedorowski A, Radico F, et al. Cardiovascular morbidity and mortality related to orthostatic hypotension: a meta-analysis of prospective observational studies. Eur Heart J. 2015 Jul 1;36(25):1609-17. doi: 10.1093/eurheartj/ehv093. Epub 2015 Apr 6.
15. Angelousi A, Girerd N, Benetos A, et al. Association between orthostatic hypotension and cardiovascular risk, cerebrovascular risk, cognitive decline and falls as well as overall mortality: a systematic review and meta-analysis. J Hypertens. 2014 Aug;32(8):1562-71; discussion 1571. doi: 10.1097/HJH.0000000000000235.
16. Rose KM, Eigenbrodt ML, Biga RL, et al. Orthostatic hypotension predicts mortality in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) study. Circulation. 2006 Aug 15;114(7):630-6. Epub 2006 Aug 7.
17. Eigenbrodt ML, Rose KM, Couper DJ, et al. Orthostatic hypotension as a risk factor for stroke: the Atherosclerosis Risk in Communities (ARIC) study, 1987-1996. Stroke. 2000 Oct;31(10):2307-13.
18. Hickler RB. Orthostatic hypotension and syncope. N Engl J Med. 1977 Feb 10;296(6):336-7.
19. Freeman R, Wieling W, Axelrod FB, et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res. 2011 Apr;21(2):69-72. doi: 10.1007/s10286-011-0119-5.
20. Brignole M, Moya A, de Lange FJ, et al. 2018 ESC Guidelines for the diagnosis and management of syncope. Eur Heart J. 2018 Jun 1; 39(21):1883-1948. doi: 10.1093/eurheartj/ehy037.
21. Ostroumova OD, Chernyaeva MS, Petrova MM, Golovina OV. Orthostatic hypotension: definition, pathophysiology, classification, prognostic aspects, diagnosis and treatment. Ratsional'naya farmakoterapiya v kardiologii. 2018;14(5):747-56. (In Russ.).
22. Finucane C, O'Connell MD, Fan CW, et al. Age-related normative changes in phasic orthostatic blood pressure in a large population study: findings from The Irish Longitudinal Study on Ageing (TILDA). Circulation. 2014 Nov 11; 130(20):1780-9. doi: 10.1161/CIRCULATIONAHA.114.009831. Epub 2014 Oct 2.
23. Cipolla MJ. Control of cerebral blood flow. In: The Cerebral Circulation. San Rafael: Morgan Claypool Life Sciences; 2009.
24. McLeod KJ, Jain T. Postural Hypotension and Cognitive Function in Older Adults. Gerontol Geriatr Med. 2017 Sep 25;3:2333721417733216. doi: 10.1177/2333721417733216. eCollection 2017 Jan-Dec.
25. Duschek S, Hadjamu M, Schandry R. Enhancement of cerebral blood flow and cognitive performance following pharmacological blood pressure elevation in chronic hypotension. Psychophysiology. 2007 Jan;44(1):145-53.
26. Cheng S, Xanthakis V, Sullivan LM, Vasan RS. Blood pressure tracking over the adult life course: patterns and correlates in the Framingham heart study. Hypertension. 2012 Dec;60(6):1393-9. doi: 10.1161/HYPERTENSIONAHA.112.201780. Epub 2012 Oct 29.
27. Ziegler MG, Rizos DP. The causes of postural cardiovascular disorders. Hypertension. 2005 Mar;45(3):354-5. Epub 2005 Feb 14.
28. Binnewjizend MA, Kuijer JP, Benedictus MR, et al. Cerebral blood flow measured with 3D pseudocontinuous arterial spin-labeling MR imaging in Alzheimer disease and mild cognitive impairment: A marker for disease severity. Radiology. 2013 Apr;267(1):221-30. doi: 10.1148/radiol.12120928. Epub 2012 Dec 13.
29. Verghese J, Lipton RB, Hall CB, et al. Low blood pressure and the risk of dementia in very old individuals. Neurology. 2003 Dec 23;61(12): 1667-72.
30. Ruitenberg A, den Heijer T, Bakkar SL, et al. Cerebral hypoperfusion and clinical onset of dementia: The Rotterdam Study. Ann Neurol. 2005 Jun;57(6):789-94.
31. Bengtsson-Lindberg ME, Larsson VS, Minthon LB, et al. Evaluation of systolic and diastolic hypotension in dementia with Lewy bodies and Alzheimer's disease. Healthy Aging & Clinical Care in the Elderly. 2013;(5):33-9. doi: 10.4137/HACCE.S12670
32. Torres RV, Elias MF, Crichton GE, et al. Systolic orthostatic hypotension is related to lowered cognitive function: Findings from the Maine-Syracuse Longitudinal Study. J Clin Hypertens (Greenwich). 2017 Dec;19(12):1357- 1365. doi: 10.1111/jch.13095.
33. Curreri C, Giantin V, Veronese N, et al. Orthostatic Changes in Blood Pressure and Cognitive Status in the Elderly: The Progetto Veneto Anziani Study. Hypertension. 2016 Aug;68(2):427-35. doi: 10.1161/HYPERTENSIONAHA.116.07334. Epub 2016 Jun 20.
34. Holm H, NКgga K, Nilsson ED, et al. Longitudinal and postural changes of blood pressure predict dementia: the MalmЪ Preventive Project. Eur J Epidemiol. 2017 Apr; 32(4):327-336. doi: 10.1007/s10654-017-0228-0. Epub 2017 Feb 11.
35. Elmstаhl S, Widerströ m E. Orthostatic intolerance predicts mild cognitive impairment: incidence of mild cognitive impairment and dementia from the Swedish general population cohort Good Aging in SkМne. Clin Interv Aging. 2014 Nov 20;9:1993-2002. doi: 10.2147/CIA.S72316. eCollection 2014.
36. Cremer A, SoumarО A, Berr C, et al. Orthostatic Hypotension and Risk of Incident Dementia: Results From a 12-Year Follow-Up of the Three-City Study Cohort. Hypertension. 2017 Jul;70(1):44-49. doi: 10.1161/HYPERTENSIONAHA.117.09048.
37. Peters R, Anstey KJ, Booth A, et al. Orthostatic hypotension and symptomatic subclinical orthostatic hypotension increase risk of cognitive impairment: an integrated evidence review and analysis of a large older adult hypertensive cohort. Eur Heart J. 2018 Sep 1;39(33): 3135-3143. doi: 10.1093/eurheartj/ehy418.
38. Wolters FJ, Mattace-Raso FU, Koudstaal PJ, et al. Orthostatic Hypotension and the Long-Term Risk of Dementia: A PopulationBased Study. PLoS Med. 2016 Oct 11;13(10): e1002143. doi: 10.1371/journal.pmed.1002143. eCollection 2016 Oct.
39. Dunlop DD, Song J, Arntson EK, et al. Sedentary time in U.S. older adults associated with disability in activities of daily living independent of physical activity. J Phys Act Health. 2015 Jan;12(1):93-101. doi: 10.1123/jpah.2013-0311. Epub 2014 Feb 5.
40. Gorelik O, Almoznino-Sarafian D, Litvinov V, et al. Seating-induced postural hypotension is common in older patients with decompensated heart failure and may be prevented by lower limb compression bandaging. Gerontology. 2009;55(2):138-44. doi: 10.1159/000141920. Epub 2008 Jun 27.
41. Cai H, Li G, Hua S, et al. Effect of exercise on cognitive function in chronic disease patients: A meta-analysis and systematic review of randomized controlled trials. Clin Interv Aging. 2017 May 11;12:773-783. doi: 10.2147/CIA.S135700. eCollection 2017.
42. Moonen JE, Foster-Dingley JC, De Ruijter W, et al. Effect of Discontinuation of Antihypertensive Treatment in Elderly People on Cognitive Functioning – the DANTE Study Leiden: A Randomized Clinical Trial. JAMA Intern Med. 2015 Oct;175(10):1622-30. doi: 10.1001/jamainternmed.2015.4103.
43. Moonen JE, Foster-Dingley JC, De Ruijter W, et al. Effect of discontinuation of antihypertensive medication on orthostatic hypotension in older persons with mild cognitive impairment: the DANTE Study Leiden. Age Ageing. 2016 Mar;45(2):249-55. doi: 10.1093/ageing/afv199.
44. Mets T. Drug-induced orthostatic hypotension in older patients. Drugs Aging. 1995 Mar; 6(3):219-28.
45. Hugues F, Munera Y, Le Jeunne C. Druginduced orthostatic hypotension. Rev Med Interne. 1992 Nov;13(6):465-70.
46. Montastruc J, Laborie I, Bagheri H, Senard M. Drug-Induced Orthostatic Hypotension: A Five-Year Experience in a Regional Pharmacovigilance Centre in France. Clin Drug Invest. 1997;14(1):61-5.
47. Verwoert G, Mattace-Raso F, Hofman A, et al. Orthostatic hypotension and risk of cardiovascular disease in elderly people: the Rotterdam study. J Am Geriatr Soc. 2008 Oct;56(10):1816-20. doi: 10.1111/j.1532-5415.2008.01946.x. Epub 2008 Sep 15.
48. Kamaruzzaman S, Watt H, Carson C, Ebrahim S. The association between orthostatic hypotension and medication use in the British Women's Heart and Health Study. Age Ageing. 2010 Jan;39(1):51-6. doi: 10.1093/ageing/afp192. Epub 2009 Nov 6.
49. Valbusa F, Labat C, Salvi P, et al. Orthostatic hypotension in very old individuals living in nursing homes: the PARTAGE study. J Hypertens. 2012 Jan;30(1):53-60. doi: 10.1097/HJH.0b013e32834d3d73.
50. Fogari R, Zoppi A, Mugellini A, et al. Efficacy and safety of two treatment combinations of hypertension in very elderly patients. Arch Gerontol Geriatr. 2009 May-Jun;48(3): 401-5. doi: 10.1016/j.archger.2008.03.012. Epub 2008 May 23.
51. Williams B, Mancia G, Spiering W, et al; ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J. 2018 Sep 1;39(33):3021-3104. doi: 10.1093/eurheartj/ehy339.
52. Vanderheyden PM, Fierens FL, De Backer JP, et al. Distinction between surmountable and insurmountable selective AT1 receptor antagonists by use of CHO-K1 cells expressing human angiotensin II AT1 receptors. Br J Pharmacol. 1999 Feb;126(4):1057-65.
53. Le MT, De Backer JP, Hunyady L, et al. Ligand binding and functional properties of human angiotensin AT1 receptors in transiently and stably expressed CHO-K1 cells. Eur J Pharmacol. 2005 Apr 18;513(1-2):35-45. Epub 2005 Apr 12.
54. Van Liefde I, Vauquelin G. Sartan-AT1 receptor interactions: in vitro evidence for insurmountable antagonism and inverse agonism. Mol Cell Endocrinol. 2009 Apr 29;302(2): 237-43. doi: 10.1016/j.mce.2008.06.006. Epub 2008 Jun 21.
55. Bhuiyan MA, Ishiguro M, Hossain M, et al. Binding sites of valsartan, candesartan and losartan with angiotensin II receptor 1 subtype by molecular modeling. Life Sci. 2009 Jul 17; 85(3-4):136-40. doi: 10.1016/j.lfs.2009.05.001. Epub 2009 May 14.
56. Lithell H, Hansson L, Skoog I, et al; SCOPE Study Group. The study on cognition and prognosis in the elderly (SCOPE). Principal results of a randomised double-blind intervention trial. J Hypertens. 2003 May;21(5):875-86.
57. Skoog I, Lithell H, Hansson L, et al. Effect of baseline cognitive function and antihypertensive treatment on cognitive and cardiovascular outcomes: Study on COgnition and Prognosis in the Elderly (SCOPE). Am J Hypertens. 2005 Aug;18(8):1052-9.
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For citations:
Ostroumova O.D., Shikh E.V., Rebrova E.V., Ryazanova A.Yu. Orthostatic hypotension as a modifiable risk factor for cognitive impairment: a literature review. Neurology, Neuropsychiatry, Psychosomatics. 2019;11(1):109-116. (In Russ.) https://doi.org/10.14412/2074-2711-2019-1-109-116
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