Abstract：
INTRODUCTION:Cognitive decline and dementia recognize multiple risk factors and pathophysiological mechanisms, often involved simultaneously with complex interactions. Several studies have shown that both arterial hypertension and hypotension are associated with a greater risk of cognitive decline and dementia, but clinical evidence on this point is conflicting. Our aim was to conduct an umbrella review on cognitive function, dementia, and blood pressure, with particular attention to epidemiological, prognostic and therapeutic aspects. EVIDENCE ACQUISITION:We conducted a dedicated literature search on PubMed for systematic reviews and meta-analyses that focused on arterial pressure, hypertension, hypotension and similar conditions, and cognitive function, cognitive decline and dementia. The internal validity of systematic reviews and meta-analyses was formally analysed using the OQAQ tool. The umbrella review was planned in accordance with current international recommendations and was described as specified by the PRISMA guidelines. EVIDENCE SYNTHESIS:17 systematic reviews (including 13 meta-analyses) were included, for a total of 675 clinical studies and over 1 million patients. Hypertension results to be associated with a lower risk of Alzheimer's dementia, greater risk of vascular dementia and greater risk of cognitive decline. Orthostatic hypotension seems to be associated with greater risk of Alzheimer's dementia, vascular dementia and dementia of Parkinson's disease. Therapy with acetylcholinesterase inhibitors produces lower risk of cardiovascular events, greater risk of hypertension and greater risk of bradycardia, while the anti-hypertensive therapy leads to a lower risk of dementia of all types and lower risk of cognitive decline. CONCLUSIONS:To date, the evidence on the relationship between blood pressure, cognitive decline and dementia provides somewhat heterogeneous data. Further studies are clearly needed, with explicit inclusion criteria as objective as possible, adequate follow-up and precise characterization of implemented cardiovascular and cognitive treatments.
journal_name
Minerva Cardioangioljournal_title
Minerva cardioangiologicaauthors
Antonazzo B,Marano G,Romagnoli E,Ronzoni S,Frati G,Sani G,Janiri L,Mazza Mdoi
10.23736/S0026-4725.20.05452-3subject
Has Abstractpub_date
2020-12-01 00:00:00eissn
0026-4725issn
1827-1618pii
S0026-4725.20.05452-3pub_type
杂志文章abstract：BACKGROUND:Among the acute effects of cigarette smoking there are an increase in the arterial blood pressure and a decrease in skin temperature. The aim of this study is to evaluate whether these effects are more evident in hypertensive subjects (HTS) than in normotensive (NTS) ones. METHODS:A monitored Ambulatory Blo...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：2003-08-01 00:00:00
abstract：:The clinical significance of coronary myocardial bridging has been debated and different interventional strategies proposed. We discuss the case of a patient who presented with the recent onset of symptoms of exertional chest pain, diaphoresis, and electrocardiographic signs of acute anterior myocardial wall ischemia....
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1998-04-01 00:00:00
abstract：OBJECTIVES:To examine the relationship between patients gender, age and the development of different types of internal carotid artery plaque. DESIGN:Prospective open clinical study. METHODS:455 carotid duplex scans with a greater than 50% stenosis were analysed in terms of gender, age, degree of stenosis symptoms and...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1997-07-01 00:00:00
abstract：:Palliative care is an alternate therapeutic approach that involves specialised medical care of a patient diagnosed with serious life threatening illness like heart failure (HF). The prime aim of the palliative care is to provide patient with relief from the symptoms, pain, physical stress, and mental stress of the dia...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,评审
doi：
更新日期：2016-02-01 00:00:00
abstract：BACKGROUND:Unstable angina implies high risk of myocardial infarction and sudden death. Increased levels of cytoplasmatic enzymes and proteins (creatine phosphokinase, MB creatine phosphokinase troponin T, etc.) were described in unstable angina, providing information about incoming major coronary events. Cardiac tropo...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1996-04-01 00:00:00
abstract：:The Authors describe a case of a patient showing, during an episode of chest pain, an ecg-pattern of wide and tall "Q" wave simulating inferior myocardial infarction. In fact, a further ecg recorded during sinus rhythm denotes that the "Q" wave was a retrograde P wave generated by a nodal rhythm. The other known cause...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1991-11-01 00:00:00
abstract：:Hypertrophic cardiomyopathy (HCM) occurs in 1 in every 500 individuals. It represents the most common cause of sudden cardiac death in those under the age of twenty-five. 3-5% patients with HCM go on to develop the dilated, hypokinetic end stage (ES) HCM with systolic failure. They have a higher incidence of heart fai...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：2012-12-01 00:00:00
abstract：BACKGROUD:This study aimed to analyze the correlations between anterior wall motion velocity of ascending aorta measured by quantitative tissue velocity image (QTVI) technique and left ventricular geometry as well as left heart function to evaluate its value of clinical application. METHODS:One hundred ten hypertensio...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：10.23736/S0026-4725.17.04535-2
更新日期：2018-04-01 00:00:00
abstract：BACKGROUND:Ablation of ventricular tachycardia is the main therapy for patients with drug-refractory VT. Although evidence suggests that VT ablation could lower the incidence of recurrent VT, many cases still develop VT in follow-up. In this study, we performed a systematic review and meta-analysis to examine risk fact...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：10.23736/S0026-4725.20.05128-2
更新日期：2020-09-29 00:00:00
abstract：:Left main coronary artery (LMCA) disease has been reported in up to 10% of all patients with coronary artery disease (CAD) and in the majority of cases are associated with severe three-vessel CAD. Among patients with chronic coronary syndrome revascularization of significant LMCA disease improves prognosis, while ther...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：10.23736/S0026-4725.20.05198-1
更新日期：2020-10-01 00:00:00
abstract：:Contrast enhanced computed tomography angiography (CTA) has seen rapid progress in its utility for the assessment of coronary artery disease (CAD) in the last few years. More and more technological enhancements have widened the horizons for the use of this non-invasive modality beyond its traditional role in assessmen...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：2013-02-01 00:00:00
abstract：AIM:It is not known whether therapy assisted by determinations of serum B-type natriuretic peptide (BNP) may improve the outcome for outpatients with chronic heart failure (CHF). METHODS:A retrospective case-control study was carried out, enrolling patients with acutely decompensated heart failure (ADHF) who were foll...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：2013-08-01 00:00:00
abstract：:Hypertrophic cardiomyopathy is a disease characterised by massive ventricular hypertrophy, reduced diastolic function and excessive ventricular contraction. It involves sections of both ventricles, but in particular the left ventricle. Although it was initially thought that this pathology might depend on a modified sy...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1990-12-01 00:00:00
abstract：BACKGROUND:Precise calcium evaluation in the aortic complex may be complicated. We aimed to assess the usefulness of a novel semi-automatic algorithm for multi slice computed tomography-derived (MSCT) quantitative estimation of aortic valve calcifications (AVC) in patients with severe aortic stenosis (AS) undergoing tr...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：10.23736/S0026-4725.18.04793-X
更新日期：2019-02-01 00:00:00
abstract：AIM:Anthracycline (ANT) chemotherapy for breast cancer, while associated with high response rates, is fraught by risks of irreversible cardiotoxicity. Unfortunately means to detect such cardiotoxicity early on and at a sublinical stage are lacking. We evaluated the role of systolic tissue Doppler imaging (TDI) in appra...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：2007-12-01 00:00:00
abstract：AIM:The aim of the present study was to investigate the behaviour of plasma adrenomedullin (AM), a hypotensive peptide, in patients with malignant (MHT) and renovascular hypertension (RVH), 2 pathologic conditions in which renin-angiotensin system (RAS) is activated and to compare them with those in essential hypertens...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：2004-08-01 00:00:00
abstract：:Ultrasound contrast agents, used with contrast-specific imaging techniques, have an established role for diagnostic cardiovascular imaging in the echocardiography laboratory. The advent of tissue harmonic imaging, albeit a significant advancement in ultrasound technology, still fail to produce diagnostically useful im...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,评审
doi：
更新日期：2009-08-01 00:00:00
abstract：:A carotid stenosis is responsible for about 30% of strokes occurring. Carotid endarterectomy (CEA) is considered to be the gold standard treatment of a carotid stenosis. Carotid angioplasty and stenting (CAS) is emerging as a new alternative treatment for a carotid artery stenosis, but the risk of neurological complic...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,评审
doi：
更新日期：2007-02-01 00:00:00
abstract：BACKGROUND:Prolonged periods of atrial fibrillation (AF) or high frequency atrial pacing lead to a significant shortening of atrial refractory periods. This time-dependent electric remodelling is reduced significantly by the administration of verapamil. METHODS:The present series consists of 24 patients all suffering ...
journal_title：Minerva cardioangiologica
pub_type： 临床试验,杂志文章
doi：
更新日期：2003-02-01 00:00:00
abstract：:An aneurysms of a renal vein is very uncommon an entity and even more so when a visceral vein is affected. The venous aneurysms are generally asymptomatic and are detected either at post-mortem examination or by Echography, CT scan or MR investigation. Occasionally they become symptomatic because of rupture, thrombosi...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1995-04-01 00:00:00
abstract：:Hypertrophic cardiomyopathy is a diverse condition, encompassing a wide spectrum of clinical manifestations. Left ventricular outflow obstruction occurs in a proportion of patients, and is amenable to a variety of management strategies. Echocardiography plays a crucial role in the diagnosis of hypertrophic cardiomyopa...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,评审
doi：
更新日期：2011-12-01 00:00:00
abstract：:Myocardial infarction in the under-40s is rare. A series of 19 patients, 3.07% of a two-year series of coronary cases, is presented with a view to evaluating the incidence of risk factors, with special attention to familial factors and dyslipoproteinaemia. Risk factors are discussed together with the statistical impor...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1989-05-01 00:00:00
abstract：:Pathophysiological remodeling of cardiac function occurs at multiple levels, spanning the spectrum from molecular and sub-cellular changes to those occurring at the organ-system levels. Of key importance to arrhythmias are changes in the electrophysiological substrate at the tissue level. In this manuscript, we provid...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,评审
doi：
更新日期：2010-04-01 00:00:00
abstract：:Recent studies have demonstrated the usefulness of myocardial contrast echocardiography (MCE) in studying myocardial perfusion. Several first and second generation contrast agent such as Levovist, Sonovue, Optison, Definity and Imagent are commercially available or close to be introduced into the market. Use of MCE al...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,评审
doi：
更新日期：2003-12-01 00:00:00
abstract：:The carotid artery is one of the most important sites in the progression of atherosclerotic lesions. Atherosclerosis is known to be determined by a variety of factors, among which arterial hypertension is one of the most important. Blood pressure control by antihypertensive treatment is thus of great benefit in manage...
journal_title：Minerva cardioangiologica
pub_type： 临床试验,杂志文章
doi：
更新日期：1994-11-01 00:00:00
abstract：AIM:The aim of this study was to evaluate the effects of low-dose niacin extended-release (niacin-ER) combined with simvastatin (SV) in the treatment of patients with mixed dyslipidemia who have not normalized their lipid profile with statin therapy alone. METHODS:A prospective, clinical trial of 35 patients with mixe...
journal_title：Minerva cardioangiologica
pub_type： 临床试验,杂志文章
doi：
更新日期：2010-10-01 00:00:00
abstract：:A patent ductus arteriosus in adults is a rare eventuality. After correct diagnosis, an accurate evaluation of pulmonary vascular resistances is necessary with, in case of normality, a straightforward indication to surgery, because the evolution of the disease cannot be predicted. In case of pulmonary hypertension irr...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1991-09-01 00:00:00
abstract：:The authors report a 57 year old patient affected by rhinopharyngeal NH lymphoma that appeared as a parapharyngeal space lesions-syncope syndrome. The activation of a cardioinhybitory reflex by the stimulation of the glossopharyngeal nerve seems to be the pathogenetic basis for his syndrome. ...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章
doi：
更新日期：1995-11-01 00:00:00
abstract：:After the introduction of coronary balloon angioplasty, bare-metal, and drug-eluting stents, fully bioresorbable scaffolds (BRS) could be the fourth revolution in interventional cardiology. The BRS technology shares the advantages of metallic stents regarding acute gain and prevention of acute vessel occlusion by prov...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,评审
doi：
更新日期：2013-04-01 00:00:00
abstract：:The risk of venous thromboembolism (VTE) increases up to 5-10-fold during pregnancy and VTE represents the first cause of maternal mortality. The annual incidence of VTE is 0.97 per 1000 women during pregnancy and 7.19 per 1000 in the puerperium. The risk is higher in carriers of inherited thrombophilia. Prophylaxis o...
journal_title：Minerva cardioangiologica
pub_type： 杂志文章,评审
doi：
更新日期：2006-12-01 00:00:00
