V prevenci demence je třeba se zaměřit na časnou a důslednou léčbu hypertenze

Title in English In the prevention of dementia, the focus should be on early and consistent treatment of hypertension
Authors

SOUČEK Miroslav

Year of publication 2023
Type Article in Periodical
Magazine / Source Vnitrni Lekarstvi
MU Faculty or unit

Faculty of Medicine

Citation
Web Fulltext na stránkách vydavatele
Doi http://dx.doi.org/10.36290/vnl.2023.047
Keywords hypertension; dementia; cognitive function; hypertension-induced end-organ damage; RAAS inhibitors; ACEI; sartans; fixed-dose triple combination of antihypertensive drugs; triplixam
Description The brain is among the target organs of hypertension. Patients with hypertension have a higher risk of developing stroke as well as experiencing a decline in cognitive functions and dementia. Changes in the white matter and atrophy of the grey matter of the brain induced by high blood pressure develop insidiously since the onset of hypertension, even in young individuals. The effect of high blood pressure on the vessel wall cumulates in time; therefore, hypertension in younger people implies an increased risk of dementia in older age. Hypertension in young age cannot be considered a benign condition. Hypertension in middle age increases the risk of dementia by 61 %. Consistent and early hypertension control can reverse the adverse development towards dementia and lack of self-sufficiency in the patient. Data comparing individual antihypertensive drugs in terms of preventing dementia are scarce. However, renin angiotensin system blockers have been found to protect against Alzheimer's disease more than other classes of antihypertensive drugs. To achieve rapid and effective hypertension control, a combination of antihypertensive drugs is usually required. Using a fixed-dose triple combination of perindopril, indapamide, and amlodipine, blood pressure targets of < 130/80 mm Hg can be achieved within three months in 93 % of patients

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