Effects of Blood Pressure Variability and Its Association With Dementia and Cognitive Impairment: A Systematic Review

Background This systematic review aimed to assess the relationship between blood pressure, cognitive function, and the potential for dementia in individuals with hypertension or at risk of developing hypertension. Methods The review adhered strictly to the Preferred Reporting Items for Sys...

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Main Authors: Aakanksha Pitliya, Aniket Jaimalani, Mizba Basheer Patel, Aditi Parulkar, Mahendra Kumar, Vanshika Batra, Sahaj Modi, Srivasta Surya Vasudevan, Anmol Pitliya
Format: Article
Language:English
Published: University Library System, University of Pittsburgh 2025-04-01
Series:International Journal of Medical Students
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Online Access:http://ijms.info/IJMS/article/view/2482
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Summary:Background This systematic review aimed to assess the relationship between blood pressure, cognitive function, and the potential for dementia in individuals with hypertension or at risk of developing hypertension. Methods The review adhered strictly to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A comprehensive search was conducted in databases, including PubMed, Research Gate, Google Scholar, and Science Direct. The inclusion criteria required studies that examined the association between blood pressure variability and the occurrence or progression of dementia and cognitive impairment. Two independent reviewers evaluated each study's quality and potential bias using study-specific tools before inclusion. Results There were a total of 17 studies, including four systematic reviews and meta-analysis, four randomized controlled trials, and nine observational studies, with a total of 16,985,492 participants. The findings indicated that late-life blood pressure had a stronger association with cognitive function than midlife blood pressure. Hypertension was linked to an increased risk of all-cause dementia, Alzheimer's disease, and vascular dementia. Anti-hypertensive medications could to reduce the risk of dementia or cognitive impairment, although the specific type of medication did not significantly affect overall cognitive performance. A significant limitation of this review was the heterogeneity in diagnostic criteria, cognitive assessment tools, and imaging techniques used among the studies, which limited direct comparisons and conclusive findings. Conclusion Blood pressure variability emerged as a potential predictor for cognitive impairment. Implementing strategies to reduce blood pressure variability may help mitigate the risk of dementia and improve cognitive outcomes in vulnerable populations.
ISSN:2076-6327