Controlling Hypertension to Prevent Cognitive Impairment
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Controlling Hypertension to Prevent Cognitive Impairment

October 10, 2019

– Hi, my name is Constantino Iadecola. I’m a neurologist at and neurobiologist at Weill Cornell Medical College in New York City. I am the director of the Feil Family Brain and Mind Research Institute, and my research interests
are in the regulation of the cerebral blood flow to the brain, as well as the implication when delivery of blood flow to
the brain is compromised, such as during stroke or dementia. I will be the keynote speaker, and the topic of this keynote lecture is on the role of hypertension in the devastating neurological diseases, including stroke and dementia. During my talk, I’m going
to give you a small overview of the factors regulating the delivery of blood flow to the brain, reminding that the brain
is uniquely dependent on a constant blood supply, and when that blood supply is compromised, the brain does not work correctly, leading either to cognitive impairment or to, in a worst-case
scenario, to acute stroke. And, after that, I will point
out how hypertension is one of the major risk-factors
for stroke and dementia. Whereas the association
between hypertension and stroke has been established
for a number of decades, the association with dementia, particularly with Alzheimer’s dementia, which is the most common form
of dementia in the elderly, has only recently been unveiled. And I will provide a
basic-size prospective on these conditions, drawing mainly from our own work in animal models of hypertension
and Alzheimer’s disease. So what are the implications of the basic science
discoveries that I will be presenting to you, with
respect to the treatment and diagnosis of stroke and dementia? I have to say that one
of the success stories of treating hypertension has
been a dramatic reduction, in some estimations up to
70%, of stroke fatality. And this provides the background for continuing
to aggressively treat hypertension, it certainly is possible. In order to decrease these devastating conditions. The association with hypertension and dementia is now becoming more clear, with respect to the fact that mid-life hypertension is associated with doubling the risk of dementia, including dementia of the Alzheimer type. This is a new realization, because vascular factors
were thought to be not major contributors to
Alzheimer’s and dementia. So the implication is that
if we treat hypertension, during mid-life, we may be able to dramatically reduce the
risk of all forms of dementia, including Alzheimer
dementia, later in life. And there is some evidence
from the literature, and from our own basic science studies, that this, indeed, may be the case, so the take-home message would be that treatment of hypertension is fundamentally
important to brain health, and we should be very
aggressive in pursuing that. In closing, then, I will be remarking on the fact that all the major threats to the mind… such as Alzheimer’s disease,
or vascular dementia, are really based upon alteration in the blood vessels of the brain that are preventable by controlling risk factors, and hypertension is the
premier risk factor, and needs to be controlled. So, my message would be that we should be very aggressive in treating hypertension, in the hope of reducing the incidents of these devastating conditions.

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