High blood pressure in dementia: How low can we go?

Yuda Turana; Jeslyn Tengkawan; Yook Chin Chia; Boon Wee Teo; Jinho Shin; Guru Prasad Sogunuru; Arieska Ann Soenarta; Huynh Van Minh; Peera Buranakitjaroen; Chen Huan Chen; Jennifer Nailes; Satoshi Hoshide; Sungha Park; Saulat Siddique; Jorge Sison; Apichard Sukonthasarn; Jam Chin Tay; Tzung Dau Wang; Narsingh Verma; Yu Qing Zhang; Ji Guang Wang; Kazuomi Kario

doi:10.1111/jch.13752

High blood pressure in dementia: How low can we go?

Yuda Turana, Jeslyn Tengkawan, Yook Chin Chia, Boon Wee Teo, Jinho Shin, Guru Prasad Sogunuru, Arieska Ann Soenarta, Huynh Van Minh, Peera Buranakitjaroen, Chen Huan Chen, Jennifer Nailes, Satoshi Hoshide, Sungha Park, Saulat Siddique, Jorge Sison, Apichard Sukonthasarn, Jam Chin Tay, Tzung Dau Wang, Narsingh Verma, Yu Qing ZhangJi Guang Wang, Kazuomi Kario

Department of Internal Medicine

Research output: Contribution to journal › Review article › peer-review

5 Citations (Scopus)

Abstract

Hypertension is an important public health concern. The prevalence keeps increasing, and it is a risk factor for several adverse health outcomes including a decline in cognitive function. Recent data also show that the prevalence of hypertension and age-related dementia is rising in Asian countries, including in the oldest old group. This study aims to discuss possible treatments for high blood pressure in the elderly and propose an optimal target for BP relative to cognitive outcomes. This review discusses several studies on related blood pressure treatments that remain controversial and the consequences if the treatment target is too low or aggressive. Longitudinal, cross-sectional, and RCT studies were included in this review. An optimum systolic blood pressure of 120-130 mm Hg is recommended, especially in nondiabetic hypertensive patients with significant risk factors. In the oldest old group of patients, hypertension might have a protective effect. The use of calcium channel blockers (CCB) and angiotensin receptor blocker (ARB) is independently associated with a decreased risk of dementia in older people. However, personalized care for patients with hypertension, especially for patients who are frail or very old, is encouraged.

Original language	English
Pages (from-to)	415-422
Number of pages	8
Journal	Journal of Clinical Hypertension
Volume	22
Issue number	3
DOIs	https://doi.org/10.1111/jch.13752
Publication status	Published - 2020 Mar 1

Bibliographical note

Funding Information:
K Kario received research grants from Omron Healthcare, Fukuda Denshi, A&D, Pfizer Japan, and honoraria from Omron Healthcare. S Park has received honoraria from Pfizer, Daiichi Sankyo, Takeda, Daewon pharmaceutical company, Boryung pharmaceutical company, and Servier. S Siddique has received honoraria from Bayer, Novartis, Pfizer, ICI, and Servier; and travel, accommodation, and conference registration support from Atco Pharmaceutical, Highnoon Laboratories, Horizon Pharma, ICI, Pfizer, and CCL. YC Chia has received honoraria and sponsorship to attend conferences and CME seminars from Abbott, Bayer, Boehringer Ingelheim, GlaxoSmithKline, Menarini, Merck Sharp & Dohme, Novartis, Orient Europharma, Pfizer, and Sanofi; and a research grant from Pfizer. J Nailes has received research grants from Pfizer. J Shin has received honoraria and sponsorship to attend seminars from Daiichi Sankyo, Takeda, Menarini, MSD, Bristol‐Myers Squibb, and Sanofi. CH Chen has served as an advisor or consultant for Novartis Pharmaceuticals Corporation; has served as a speaker or a member of a speakers bureau for AstraZeneca; Pfizer Inc; Bayer AG; Bristol‐Myers Squibb Company; Boehringer Ingelheim Pharmaceuticals, Inc; Daiichi Sankyo, Inc; Novartis Pharmaceuticals Corporation; SERVIER; Merck & Co., Inc; Sanofi; TAKEDA Pharmaceuticals International; and has received grants for clinical research from Microlife Co., Ltd. J Sison has received honoraria from Pfizer, AstraZeneca, AmGen, Boehringer Ingelheim, and Novartis. GP Sogunuru has received a research grant related to hypertension monitoring and treatment from Pfizer. JG Wang has received research grants from Bayer, Merck Sharp & Dohme, Pfizer, and Phillips; and lecture and consulting fees from Bayer, Daiichi‐Sankyo, Merck Sharp & Dohme, Pfizer, Servier and Takeda. TD Wang has received honoraria from Abbott, AstraZeneca, Boehringer Ingelheim, Daiichi Sankyo, Eli Lilly, Medtronic, Menarini, Novartis, Omron, Pfizer, Sanofi, and Servier. Y Zhang has received research grants from Bayer, Novartis, and Shuanghe; and lecture fees from Bayer, Daiichi Sankyo, Novartis, Pfizer, Sanofi, Servier, and Takeda. All other authors report no potential conflicts of interest in relation to this article.

Publisher Copyright:
© 2019 Wiley Periodicals, Inc.

All Science Journal Classification (ASJC) codes

Internal Medicine
Endocrinology, Diabetes and Metabolism
Cardiology and Cardiovascular Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/jch.13752

Cite this

Turana, Y., Tengkawan, J., Chia, Y. C., Teo, B. W., Shin, J., Sogunuru, G. P., Soenarta, A. A., Minh, H. V., Buranakitjaroen, P., Chen, C. H., Nailes, J., Hoshide, S., Park, S., Siddique, S., Sison, J., Sukonthasarn, A., Tay, J. C., Wang, T. D., Verma, N., ... Kario, K. (2020). High blood pressure in dementia: How low can we go? Journal of Clinical Hypertension, 22(3), 415-422. https://doi.org/10.1111/jch.13752

@article{a5c00e2c21b142238c087647f44eb6c5,

title = "High blood pressure in dementia: How low can we go?",

abstract = "Hypertension is an important public health concern. The prevalence keeps increasing, and it is a risk factor for several adverse health outcomes including a decline in cognitive function. Recent data also show that the prevalence of hypertension and age-related dementia is rising in Asian countries, including in the oldest old group. This study aims to discuss possible treatments for high blood pressure in the elderly and propose an optimal target for BP relative to cognitive outcomes. This review discusses several studies on related blood pressure treatments that remain controversial and the consequences if the treatment target is too low or aggressive. Longitudinal, cross-sectional, and RCT studies were included in this review. An optimum systolic blood pressure of 120-130 mm Hg is recommended, especially in nondiabetic hypertensive patients with significant risk factors. In the oldest old group of patients, hypertension might have a protective effect. The use of calcium channel blockers (CCB) and angiotensin receptor blocker (ARB) is independently associated with a decreased risk of dementia in older people. However, personalized care for patients with hypertension, especially for patients who are frail or very old, is encouraged.",

author = "Yuda Turana and Jeslyn Tengkawan and Chia, {Yook Chin} and Teo, {Boon Wee} and Jinho Shin and Sogunuru, {Guru Prasad} and Soenarta, {Arieska Ann} and Minh, {Huynh Van} and Peera Buranakitjaroen and Chen, {Chen Huan} and Jennifer Nailes and Satoshi Hoshide and Sungha Park and Saulat Siddique and Jorge Sison and Apichard Sukonthasarn and Tay, {Jam Chin} and Wang, {Tzung Dau} and Narsingh Verma and Zhang, {Yu Qing} and Wang, {Ji Guang} and Kazuomi Kario",

note = "Funding Information: K Kario received research grants from Omron Healthcare, Fukuda Denshi, A&D, Pfizer Japan, and honoraria from Omron Healthcare. S Park has received honoraria from Pfizer, Daiichi Sankyo, Takeda, Daewon pharmaceutical company, Boryung pharmaceutical company, and Servier. S Siddique has received honoraria from Bayer, Novartis, Pfizer, ICI, and Servier; and travel, accommodation, and conference registration support from Atco Pharmaceutical, Highnoon Laboratories, Horizon Pharma, ICI, Pfizer, and CCL. YC Chia has received honoraria and sponsorship to attend conferences and CME seminars from Abbott, Bayer, Boehringer Ingelheim, GlaxoSmithKline, Menarini, Merck Sharp & Dohme, Novartis, Orient Europharma, Pfizer, and Sanofi; and a research grant from Pfizer. J Nailes has received research grants from Pfizer. J Shin has received honoraria and sponsorship to attend seminars from Daiichi Sankyo, Takeda, Menarini, MSD, Bristol‐Myers Squibb, and Sanofi. CH Chen has served as an advisor or consultant for Novartis Pharmaceuticals Corporation; has served as a speaker or a member of a speakers bureau for AstraZeneca; Pfizer Inc; Bayer AG; Bristol‐Myers Squibb Company; Boehringer Ingelheim Pharmaceuticals, Inc; Daiichi Sankyo, Inc; Novartis Pharmaceuticals Corporation; SERVIER; Merck & Co., Inc; Sanofi; TAKEDA Pharmaceuticals International; and has received grants for clinical research from Microlife Co., Ltd. J Sison has received honoraria from Pfizer, AstraZeneca, AmGen, Boehringer Ingelheim, and Novartis. GP Sogunuru has received a research grant related to hypertension monitoring and treatment from Pfizer. JG Wang has received research grants from Bayer, Merck Sharp & Dohme, Pfizer, and Phillips; and lecture and consulting fees from Bayer, Daiichi‐Sankyo, Merck Sharp & Dohme, Pfizer, Servier and Takeda. TD Wang has received honoraria from Abbott, AstraZeneca, Boehringer Ingelheim, Daiichi Sankyo, Eli Lilly, Medtronic, Menarini, Novartis, Omron, Pfizer, Sanofi, and Servier. Y Zhang has received research grants from Bayer, Novartis, and Shuanghe; and lecture fees from Bayer, Daiichi Sankyo, Novartis, Pfizer, Sanofi, Servier, and Takeda. All other authors report no potential conflicts of interest in relation to this article. Publisher Copyright: {\textcopyright} 2019 Wiley Periodicals, Inc.",

year = "2020",

month = mar,

day = "1",

doi = "10.1111/jch.13752",

language = "English",

volume = "22",

pages = "415--422",

journal = "Journal of Clinical Hypertension",

issn = "1524-6175",

publisher = "Wiley-Blackwell",

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Turana, Y, Tengkawan, J, Chia, YC, Teo, BW, Shin, J, Sogunuru, GP, Soenarta, AA, Minh, HV, Buranakitjaroen, P, Chen, CH, Nailes, J, Hoshide, S, Park, S, Siddique, S, Sison, J, Sukonthasarn, A, Tay, JC, Wang, TD, Verma, N, Zhang, YQ, Wang, JG & Kario, K 2020, 'High blood pressure in dementia: How low can we go?', Journal of Clinical Hypertension, vol. 22, no. 3, pp. 415-422. https://doi.org/10.1111/jch.13752

TY - JOUR

T1 - High blood pressure in dementia

T2 - How low can we go?

AU - Turana, Yuda

AU - Tengkawan, Jeslyn

AU - Chia, Yook Chin

AU - Teo, Boon Wee

AU - Shin, Jinho

AU - Sogunuru, Guru Prasad

AU - Soenarta, Arieska Ann

AU - Minh, Huynh Van

AU - Buranakitjaroen, Peera

AU - Chen, Chen Huan

AU - Nailes, Jennifer

AU - Hoshide, Satoshi

AU - Park, Sungha

AU - Siddique, Saulat

AU - Sison, Jorge

AU - Sukonthasarn, Apichard

AU - Tay, Jam Chin

AU - Wang, Tzung Dau

AU - Verma, Narsingh

AU - Zhang, Yu Qing

AU - Wang, Ji Guang

AU - Kario, Kazuomi

N1 - Funding Information: K Kario received research grants from Omron Healthcare, Fukuda Denshi, A&D, Pfizer Japan, and honoraria from Omron Healthcare. S Park has received honoraria from Pfizer, Daiichi Sankyo, Takeda, Daewon pharmaceutical company, Boryung pharmaceutical company, and Servier. S Siddique has received honoraria from Bayer, Novartis, Pfizer, ICI, and Servier; and travel, accommodation, and conference registration support from Atco Pharmaceutical, Highnoon Laboratories, Horizon Pharma, ICI, Pfizer, and CCL. YC Chia has received honoraria and sponsorship to attend conferences and CME seminars from Abbott, Bayer, Boehringer Ingelheim, GlaxoSmithKline, Menarini, Merck Sharp & Dohme, Novartis, Orient Europharma, Pfizer, and Sanofi; and a research grant from Pfizer. J Nailes has received research grants from Pfizer. J Shin has received honoraria and sponsorship to attend seminars from Daiichi Sankyo, Takeda, Menarini, MSD, Bristol‐Myers Squibb, and Sanofi. CH Chen has served as an advisor or consultant for Novartis Pharmaceuticals Corporation; has served as a speaker or a member of a speakers bureau for AstraZeneca; Pfizer Inc; Bayer AG; Bristol‐Myers Squibb Company; Boehringer Ingelheim Pharmaceuticals, Inc; Daiichi Sankyo, Inc; Novartis Pharmaceuticals Corporation; SERVIER; Merck & Co., Inc; Sanofi; TAKEDA Pharmaceuticals International; and has received grants for clinical research from Microlife Co., Ltd. J Sison has received honoraria from Pfizer, AstraZeneca, AmGen, Boehringer Ingelheim, and Novartis. GP Sogunuru has received a research grant related to hypertension monitoring and treatment from Pfizer. JG Wang has received research grants from Bayer, Merck Sharp & Dohme, Pfizer, and Phillips; and lecture and consulting fees from Bayer, Daiichi‐Sankyo, Merck Sharp & Dohme, Pfizer, Servier and Takeda. TD Wang has received honoraria from Abbott, AstraZeneca, Boehringer Ingelheim, Daiichi Sankyo, Eli Lilly, Medtronic, Menarini, Novartis, Omron, Pfizer, Sanofi, and Servier. Y Zhang has received research grants from Bayer, Novartis, and Shuanghe; and lecture fees from Bayer, Daiichi Sankyo, Novartis, Pfizer, Sanofi, Servier, and Takeda. All other authors report no potential conflicts of interest in relation to this article. Publisher Copyright: © 2019 Wiley Periodicals, Inc.

PY - 2020/3/1

Y1 - 2020/3/1

N2 - Hypertension is an important public health concern. The prevalence keeps increasing, and it is a risk factor for several adverse health outcomes including a decline in cognitive function. Recent data also show that the prevalence of hypertension and age-related dementia is rising in Asian countries, including in the oldest old group. This study aims to discuss possible treatments for high blood pressure in the elderly and propose an optimal target for BP relative to cognitive outcomes. This review discusses several studies on related blood pressure treatments that remain controversial and the consequences if the treatment target is too low or aggressive. Longitudinal, cross-sectional, and RCT studies were included in this review. An optimum systolic blood pressure of 120-130 mm Hg is recommended, especially in nondiabetic hypertensive patients with significant risk factors. In the oldest old group of patients, hypertension might have a protective effect. The use of calcium channel blockers (CCB) and angiotensin receptor blocker (ARB) is independently associated with a decreased risk of dementia in older people. However, personalized care for patients with hypertension, especially for patients who are frail or very old, is encouraged.

AB - Hypertension is an important public health concern. The prevalence keeps increasing, and it is a risk factor for several adverse health outcomes including a decline in cognitive function. Recent data also show that the prevalence of hypertension and age-related dementia is rising in Asian countries, including in the oldest old group. This study aims to discuss possible treatments for high blood pressure in the elderly and propose an optimal target for BP relative to cognitive outcomes. This review discusses several studies on related blood pressure treatments that remain controversial and the consequences if the treatment target is too low or aggressive. Longitudinal, cross-sectional, and RCT studies were included in this review. An optimum systolic blood pressure of 120-130 mm Hg is recommended, especially in nondiabetic hypertensive patients with significant risk factors. In the oldest old group of patients, hypertension might have a protective effect. The use of calcium channel blockers (CCB) and angiotensin receptor blocker (ARB) is independently associated with a decreased risk of dementia in older people. However, personalized care for patients with hypertension, especially for patients who are frail or very old, is encouraged.

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JO - Journal of Clinical Hypertension

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ER -

High blood pressure in dementia: How low can we go?

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

UN SDGs

Access to Document

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