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Antihypertensives for combating dementia? A perspective on candidate molecular mechanisms and population-based prevention

Age-related increases in prevalent dementia over the next 30–40 years risk collapsing medical resources or radically altering the way we treat patients. Better prevention of dementia therefore needs to be one of our highest medical priorities. We propose a perspective on the pathological basis of de...

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Detalles Bibliográficos
Autores principales: Valenzuela, M, Esler, M, Ritchie, K, Brodaty, H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337069/
https://www.ncbi.nlm.nih.gov/pubmed/22832907
http://dx.doi.org/10.1038/tp.2012.28
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author Valenzuela, M
Esler, M
Ritchie, K
Brodaty, H
author_facet Valenzuela, M
Esler, M
Ritchie, K
Brodaty, H
author_sort Valenzuela, M
collection PubMed
description Age-related increases in prevalent dementia over the next 30–40 years risk collapsing medical resources or radically altering the way we treat patients. Better prevention of dementia therefore needs to be one of our highest medical priorities. We propose a perspective on the pathological basis of dementia based on a cerebrovascular-Alzheimer disease spectrum that provides a more powerful explanatory framework when considering the impact of possible public health interventions. With this in mind, a synthesis of evidence from basic, clinical and epidemiological studies indeed suggests that the enhanced treatment of hypertension could be effective for the primary prevention of dementia of either Alzheimer or vascular etiology. In particular, we focus on candidate preventative mechanisms, including reduced cerebrovascular disease, disruption of hypoxia-dependent amyloidogenesis and the potential neuroprotective properties of calcium channel blockers. Following the successful translation of large, long-term and resource-intense trials in cardiology into improved vascular health outcomes in many countries, new multinational prevention trials with dementia-related primary outcomes are now urgently required.
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spelling pubmed-33370692012-04-25 Antihypertensives for combating dementia? A perspective on candidate molecular mechanisms and population-based prevention Valenzuela, M Esler, M Ritchie, K Brodaty, H Transl Psychiatry Perspective Age-related increases in prevalent dementia over the next 30–40 years risk collapsing medical resources or radically altering the way we treat patients. Better prevention of dementia therefore needs to be one of our highest medical priorities. We propose a perspective on the pathological basis of dementia based on a cerebrovascular-Alzheimer disease spectrum that provides a more powerful explanatory framework when considering the impact of possible public health interventions. With this in mind, a synthesis of evidence from basic, clinical and epidemiological studies indeed suggests that the enhanced treatment of hypertension could be effective for the primary prevention of dementia of either Alzheimer or vascular etiology. In particular, we focus on candidate preventative mechanisms, including reduced cerebrovascular disease, disruption of hypoxia-dependent amyloidogenesis and the potential neuroprotective properties of calcium channel blockers. Following the successful translation of large, long-term and resource-intense trials in cardiology into improved vascular health outcomes in many countries, new multinational prevention trials with dementia-related primary outcomes are now urgently required. Nature Publishing Group 2012-04 2012-04-24 /pmc/articles/PMC3337069/ /pubmed/22832907 http://dx.doi.org/10.1038/tp.2012.28 Text en Copyright © 2012 Macmillan Publishers Limited http://creativecommons.org/licenses/by-nc-nd/3.0/ This work is licensed under the Creative Commons Attribution-NonCommercial-No Derivative Works 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/3.0/
spellingShingle Perspective
Valenzuela, M
Esler, M
Ritchie, K
Brodaty, H
Antihypertensives for combating dementia? A perspective on candidate molecular mechanisms and population-based prevention
title Antihypertensives for combating dementia? A perspective on candidate molecular mechanisms and population-based prevention
title_full Antihypertensives for combating dementia? A perspective on candidate molecular mechanisms and population-based prevention
title_fullStr Antihypertensives for combating dementia? A perspective on candidate molecular mechanisms and population-based prevention
title_full_unstemmed Antihypertensives for combating dementia? A perspective on candidate molecular mechanisms and population-based prevention
title_short Antihypertensives for combating dementia? A perspective on candidate molecular mechanisms and population-based prevention
title_sort antihypertensives for combating dementia? a perspective on candidate molecular mechanisms and population-based prevention
topic Perspective
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337069/
https://www.ncbi.nlm.nih.gov/pubmed/22832907
http://dx.doi.org/10.1038/tp.2012.28
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