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Vascular Cognitive Impairment and Alzheimer Disease: Are These Disorders Linked to Hypertension and Other Cardiovascular Risk Factors?

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Hypertension and Stroke

Part of the book series: Clinical Hypertension and Vascular Diseases ((CHVD))

Abstract

Alzheimer disease (AD) and vascular forms of cognitive impairment (VCI) traditionally have been considered separate or divergent disorders (Clin Geriatr Med. 1991;7(3):599–615). AD, for example, has been defined as a “degenerative” disease characterized by neuritic plaque and neurofibrillary tangle pathology, neuronal loss, and deposition of amyloid in the brain parenchyma and brain blood vessels. On the other hand, VCI has been defined as disorders caused by cerebrovascular brain injury which may vary from mild to severe cognitive dysfunction (Stroke. 2004;35(11 Suppl 1):2620–2). Practically, mixed neuropathology including both AD and VCI is common in the elderly, and vascular risk factors and atherosclerosis may be important in the genesis of both VCI and AD (Stroke. 2005;36(4):875–9; Neurology. 1999;52(6):1114–5; Alzheimer Dis Assoc Disord. 1999;13 Suppl 3:S131–9; Neurology. 1994;44(8):1391–6). Furthermore, AD and stroke pathogenic mechanisms may be synergistic (Stroke. 2003;34(2):335–7). In this chapter, we review the evidence linking vascular risk factors to the development of AD and VCI. In addition, we discuss the potential effect of vascular risk factor modification on the prevention of cognitive decline.

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Authors and Affiliations

  1. Department of Neurology and Rehabilitation, College of Medicine at Chicago, University of Illinois, 912 S Wood St, Chicago, IL, 60612, USA

    Fernando D. Testai M.D., Ph.D.

  2. Department of Translational Science and Molecular Medicine, College of Human Medicine, Michigan State University, 220 Cherry Street SE Room H 3037, Grand Rapids, MI, 49503, USA

    Philip B. Gorelick M.D., M.P.H., F.A.C.P. (Professor, Medical Director)

  3. Mercy Health Hauenstein Neurosciences, 220 Cherry Street SE Room H 3037, Grand Rapids, MI, 49503, USA

    Philip B. Gorelick M.D., M.P.H., F.A.C.P. (Professor, Medical Director)

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  1. Fernando D. Testai M.D., Ph.D.
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  1. Departments of Neurological Surgery and Neurology and Neurotherapeutics , University of Texas Southwestern Medical Center , Dallas, Texas, USA

    Venkatesh Aiyagari

  2. Michigan State University Department of Translational Science & Molecular Medicine, Mercy Health Hauenstein Neurosciences, Grand Rapids, Michigan, USA

    Philip B. Gorelick

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Testai, F.D., Gorelick, P.B. (2016). Vascular Cognitive Impairment and Alzheimer Disease: Are These Disorders Linked to Hypertension and Other Cardiovascular Risk Factors?. In: Aiyagari, V., Gorelick, P. (eds) Hypertension and Stroke. Clinical Hypertension and Vascular Diseases. Humana Press, Cham. https://doi.org/10.1007/978-3-319-29152-9_15

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