Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Hypertension and cognitive impairment: the standpoint of evidence-based medicine

Full Text:


Hypertension is one of the main modifiable risk factors for cognitive impairment (CI) and dementia in middle-aged and elderly patients. CI occurs in patients with hypertension even with its short duration and is manifested by controlling dysfunctiona and cognitive speed decline. The paper presents the results of a neuropsychological examination in 50 patients of middle age (47.54±5.2 years) with short-term (2.6±5.5 years) and uncomplicated hypertension. Stable blood pressure normalization during antihypertensive therapy improves cognitive function and prevents the progression of CI and the development of dementia. The use of nicergoline in patients with hypertension and CI is  discussed.

About the Authors

T. M. Ostroumova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Department of Nervous System Diseases and Neurosurgery

11, Rossolimo St., Moscow 119021

V. A. Parfenov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Department of Nervous System Diseases and Neurosurgery

11, Rossolimo St., Moscow 119021

O. D. Ostroumova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia
Russian Federation

Department of Nervous System Diseases and Neurosurgery

11, Rossolimo St., Moscow 119021

20/1, Delegatskaya St., Moscow 127423


1. Диагностика и лечение артериальной гипертензии. Системные гипертензии 2010; 3: 5–26. [Diagnosis and treatment of hypertension. Sistemnye gipertenzii 2010; 3: 5-26. (In Russ.)].

2. Cerhan JR, Folsom AR, Mortimer JA, Shahar E, Knopman DS, McGovern PG, Hays MA, Crum LD, Heiss G. Correlates of cognitive function in middle-aged adults: Atherosclerosis Risk in Communities (ARIC) Study Investigators. Gerontology. 1998;44: 95-105. PMID:9523221

3. Obisesan TO, Obisesan OA, Martins S, Alamgir L, Bond V, Maxwell C, Gillum RF. High blood pressure, hypertension, and high pulse pressure are associated with poorer cognitive function in persons aged 60 and older: the Third National Health and Nutrition Examination Survey. J Am Geriatr Soc. 2008; 56:501-509. doi: 10.1111/j.1532-5415.2007.01592.x.

4. Kuo HK, Sorond F, Iloputaife I, Gagnon M, Milberg W, Lipsitz LA. Effect of blood pressure on cognitive functions in elderly persons. J Gerontol A Biol Sci Med Sci. 2004;59:1191-1194. PMID:15602074 PMCID:PMC4418553

5. Waldstein SR, Giggey PP, Thayer JF, Zonderman AB. Nonlinear relations of blood pressure to cognitive function: the Baltimore Longitudinal Study of Aging. Hypertension. 2005;45:374-379. doi: 10.1161/01. HYP.0000156744.44218.74.

6. Dregan A, Stewart R, Gulliford MC. Cardiovascular risk factors and cognitive decline in adults aged 50 and over: a population-based cohort study. Age Ageing. 2013;42:338-345. doi: 10.1093/ageing/afs166.

7. Knopman D, Boland LL, Mosley T, Howard G, Liao D, Szklo M, McGovern P, Folsom AR; Atherosclerosis Risk in Communities (ARIC) Study Investigators. Cardiovascular risk factors and cognitive decline in middle-aged adults. Neurology. 2001;56:42-48. PMID:11148234

8. Yasar S, Ko JY, Nothelle S, Mielke MM, Carlson MC. Evaluation of the effect of systolic blood pressure and pulse pressure on cognitive function: the Women's Health and Aging Study II. PLoS One. 2011;6:e27976. doi: 10.1371/journal.pone.0027976.

9. Bohannon AD, Fillenbaum GG, Pieper CF, Hanlon JT, Blazer DG. Relationship of race/ ethnicity and blood pressure to change in cognitive function. J Am Geriatr Soc. 2002;50: 424-429.

10. Парфенов В.А., Старчина Ю.А. Когнитивные нарушения у пациентов с артериальной гипертензией и их лечение. Неврология, нейропсихиатрия, психосоматика 2011;3(1):27-33. [Parfenov VA, Starchina YuA. Cognitive impairment in patients with hypertension and their treatment. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2011;3(1): 27-33. (In Russ.)].

11. Swan GE, Carmelli D, Larue A. Systolic blood pressure tracking over 25 to 30 years and cognitive performance in older adults. Stroke 1998;29:2334-2340.

12. Kilander L, Nyman H, Boberg M, Hansson L, Lithell H. Hypertension is related to cognitive impairment: a 20-year follow-up of 999 men. Hypertension. 1998;31:780-786.

13. Launer LJ, Masaki K, Petrovitch H, Foley D, Havlik RJ. The association between midlife blood pressure levels and late-life cognitive function: the Honolulu-Asia Aging Study. JAMA. 1995;274:1846-1851. PMID:7500533

14. Elias MF, Wolf PA, D'Agostino RB, Cobb J, White LR. Untreated blood pressure level is inversely related to cognitive functioning: the Framingham Study. Am J Epidemiol. 1993; 138:353-364.

15. Kilander L, Nyman H, Boberg M, Lithell H. The association between low diastolic blood pressure in middle age and cognitive function in old age: a population-based study. Age Ageing. 2000;29:243-248.

16. Elias PK, Elias MF, Robbins MA, Budge MM. Blood pressurerelated cognitive decline: does age make a difference? Hypertension. 2004;44:631-636. doi: 10.1161/01.HYP.0000145858.07252.99.

17. Debette S, Seshadri S, Beiser A, Au R, Himali JJ, Palumbo C, Wolf PA, DeCarli C. Midlife vascular risk factor exposure accelerates structural brain aging and cognitive decline. Neurology. 2011;77:461-468. doi: 10.1212/WNL.0b013e318227b227.

18. Kohler S, Baars MA, Spauwen P, Schievink S, Verhey FR, van Boxtel MJ. Temporal evolution of cognitive changes in incident hypertension: prospective cohort study across the adult age span. Hypertension. 2014;63:245-251. doi: 10.1161/HYPERTENSIONAHA.113.02096.

19. Gottesman RF, Schneider AL, Albert M, Alonso A, Bandeen-Roche K, Coker L, Coresh J, Knopman D, Power MC, Rawlings A, Sharrett AR, Wruck LM, Mosley TH. Midlife hypertension and 20-year cognitive change: the Atherosclerosis Risk in Communities neurocognitive study. JAMA Neurol. 2014;71:1218-1227. doi: 10.1001/jamaneurol.2014.1646.

20. Cattell RB. Abilities: Their structure, growth, and action. New York 1971 : Houghton Mifflin, 583 p. ISBN 0395042755.

21. Старчина Ю.А., Парфенов В.А., Чазова И.Е. и др. Когнитивные расстройства у пациентов с артериальной гипертензией. Журнал неврологии и психиатрии им. С.С. Корсакова 2008;4:39-43. [Starchina YuA, Parfenov VA, Chazova IE, et al. Cognitive function and emotional status of stroke patients on the background of antihypertensive therapy. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2005;(15):39-44. (In Russ.)].

22. Захаров В.В., Вахнина Н.В. Когнитивные нарушения при артериальной гипертензии. Нервные болезни 2013; 3: 16-21. [Zaharov V.V., Vahnina N.V. Cognitive disorders in arterial hypertension. Nervnye bolezni 2013; 3: 16-21. (In Russ.)].

23. Van Boxtel MPJ, Henskens LHG, Kroon AA et al. Ambulatory blood pressure, asymptomatic cerebrovascular damage and cognitive function in essential hypertension. Journal of human hypertension 2006; 20(1):5-13. doi: 10.4061/2011/478710

24. Яхно НН. Когнитивные расстройства в неврологической клинике. Неврологический журнал. 2006;11(Прил 1):4-12. [Yakhno NN. Cognitive impairments in neurological clinic. Nevrologicheskii zhurnal. 2006; 11(Pril 1):4-12. (In Russ.)].

25. Forette F, Seux ML, Staessen JA, et al. for the Syst-Eur Investigators. The Prevention of Dementia with Antihypertensive Treatment. New evidence from the Systolic Hypertension (Syst-Eur) Study. Arch Intern Med 2002; 162(18): 2046-2052. PMID:12374512

26. 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 doubleblind intervention trial. J Hypertens 2003; 21: 875-86. PMID:10595696

27. PROGRESS collaborative study group. Randomised trial of perindopril based blood pressure-lowering regimen among 6108 individuals with previous stroke or transient ischaemic attack. Lancet 2001; 358:1033-41. doi: 10.1016/S0140-6736(01)06178-5

28. Marpillat NL, Macquin-Mavier I, Tropeano AI, Bachoud-Levi AC, Maison P. Antihypertensive classes, cognitive decline andincidence of dementia: a networkmeta- analysis. Journal of Hypertension 2013, 31 (6):1073-82. doi: 10.1097/HJH.0b013e3283603f53.

29. Chiu WC, Ho WC, Lin MH, Lee HH, Yeh YCh, Wang JD, Chen PCh, Health Data Analysis in Taiwan (hDATa) Research Group. Angiotension receptor blockers reduce the risk of dementia. Journal of Hypertension 2014, 32: 938-947. doi: 10.1097/HJH.0000000000000086.

30. Морозов ПВ. Клиническое применение Сермиона (ницерголина). Consilium Medicum (прил.) 2010; 9: 43–47. [Morozov PV. Clinical application of Sermion (nicergoline). Consilium Medicum (prilozhenie) 2010; 9: 43–47. (In Russ.)]

31. Alvarez-Guerra M, Bertholom N, Garay RP. Selective blockade by nicergoline of vascular responses elicited by stimulation of alphaiA-adrenoceptorsubtype in the rat. Fundam. Clin. Pharmacol 1999; 13 (1): 50-8.

32. Winblad B, Fioravanti M, Dolezal T, Logina I, Milanov IG, Popescu DC, Solomon A. Therapeutic use of nicergoline. Clin. Drug Investig., 2008; 28 (9): 533-552.

33. Bes A, Orgogozo JM, Poncet M, Rancurel G, Weber M, Bertholom N, Calvez R, Stehle B. A 24-month, double-blind, placebocontrolled multicentre pilot study of the efficacy and safety of nicergoline 60 mg per day in elderly hypertensive patients with leukoaraiosis. Eur J Neurol. 1999;6(3):313-22. PMID:10210912

34. Свищенко ЕП, Безродная ЛВ, Гулкевич ОВ. Высокие дозы СЕРМИОНА — новый подход к лечению больных с цереброваскулярной патологией. Укр. мед. часопис 1999;№4(12):54–57. [Svishchenko E.P., Bezrodnaya L V, Gulkevich O V. High doses of SERMON - a new approach to the treatment of patients with cerebrovascular pathology. Ukr. med. chasopis 1999;№4(12):54–57. (In Russ.)].

35. Boulu P. Effects du Sermion sur les troubles mnesiques et les fonctions de la vie de relation. Analyse d'une population de 1 o 488 patients, a terrain vasculaire, suivis pendant 6 mois. Tempo medical 1990;397:24-27.


For citations:

Ostroumova T.M., Parfenov V.A., Ostroumova O.D. Hypertension and cognitive impairment: the standpoint of evidence-based medicine. Neurology, Neuropsychiatry, Psychosomatics. 2017;9(4):70-76. (In Russ.)

Views: 715

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)