HIPOTENSION ORTOSTATICA Y DETERIORO COGNITIVO/DEMENCIA EN ADULTOS

(especial para SIIC © Derechos reservados)
La autora sugiere que tanto la hipoperfusión cerebral como el daño celular podrían explicar, al menos parcialmente, la vinculación entre la HTO y las alteraciones cognitivas descriptas en la bibliografía. Estudios realizados en el futuro podrán identificar los mecanismos que expliquen la asociación entre HTO y deterioro cognitivo.
Autor:
Mariana Suárez bagnasco
Columnista Experta de SIIC

Institución:
Universidad Católica del Uruguay


Artículos publicados por Mariana Suárez bagnasco
Recepción del artículo
27 de Agosto, 2019
Aprobación
16 de Enero, 2020
Primera edición
29 de Enero, 2020
Segunda edición, ampliada y corregida
12 de Agosto, 2021

Resumen
Se realizó una revisión narrativa sobre la hipotensión ortostática (HTO) y el deterioro cognitivo/la demencia. Se utilizaron las bases de datos PubMed y PsycInfo. Se identificaron los estudios originales publicados en idioma inglés entre 2013 y 2018, inclusive. Las palabras clave utilizadas durante la búsqueda fueron las siguientes: "orthostatic hypotension", "adults" and "cognitive"/ "cognitive impairment"/ "dementia". Se encontraron 20 estudios originales que exploran la relación entre la HTO y el/la deterioro cognitivo/demencia. La mayoría de los trabajos revisados aportan datos a favor de la existencia de una asociación entre HTO y deterioro cognitivo/demencia en adultos: 8 de 11 trabajos suministran información a favor de la existencia de una asociación entre HTO y deterioro cognitivo, 6 de 7 estudios brindan datos a favor de la existencia de una asociación entre HTO y demencia, y 2 trabajos aportan datos a favor de la asociación entre HTO y deterioro cognitivo leve. Los autores sugieren que tanto la hipoperfusión cerebral como el daño celular podrían explicar, al menos parcialmente, la vinculación entre la HTO y las alteraciones cognitivas descriptas en la bibliografía. Estudios realizados en el futuro podrán identificar los mecanismos que expliquen la asociación entre HTO y deterioro cognitivo, así como entre HTO y demencia en adultos, con el fin de reducir el riesgo de deterioro cognitivo/demencia o, al menos, enlentecer su progresión.

Palabras clave
presión arterial


Artículo completo

(castellano)
Extensión:  +/-4.6 páginas impresas en papel A4
Exclusivo para suscriptores/assinantes

Abstract
A narrative review was made on orthostatic hypotension and cognitive impairment / dementia. The PubMed and PsycInfo databases were used and the original studies published in English between 2013 and 2018 were identified. The keywords used during the search were the following: "orthostatic hypotension", "adults" and "cognitive" / "cognitive impairment" / "dementia". We found 20 original studies that explore the relationship between orthostatic hypotension and cognitive / dementia. Most of the studies reviewed provide evidence in favor of the existence of an association between orthostatic hypotension and cognitive impairment / dementia in adults: 8 out of 11 papers provide evidence in favor of the existence of an association between orthostatic hypotension and cognitive impairment, 6 out of 7 papers provide evidence in favor of the existence of an association between orthostatic hypotension and dementia, and 2 out of 2 papers provide evidence in favor of the existence of an association between orthostatic hypotension and mild cognitive impairment. The authors suggest that both brain hypoperfusion and cellular damage could partially explain the link between orthostatic hypotension and the cognitive disorders described in the literature. Future studies may identify mechanisms that explain the association between orthostatic hypotension and cognitive impairment / orthostatic hypotension and dementia in adults to reduce the risk of cognitive impairment / dementia or at least slow down its progression.

Key words
blood pressure


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Cardiología, Neurología
Relacionadas: Geriatría, Medicina Familiar, Salud Mental, Salud Pública



Comprar este artículo
Extensión: 4.6 páginas impresas en papel A4

file05.gif (1491 bytes) Artículos seleccionados para su compra



Enviar correspondencia a:
Mariana Suárez Bagnasco, Universidad Católica del Uruguay, Montevideo, Uruguay
Bibliografía del artículo
1. Freeman R, Abuzinadah AR, Gibbons C, Jones P, Miglis MG, Sinn DI. Orthostatic Hypotension: JACC State-of-the-Art Review. J Am Coll Cardiol 72(11):1294-1309, 2018. doi: 10.1016/j.jacc.2018.05.079.
2. Bengtsson-Lindberg M, Larsson V, Minthon L, Wattmo C, Londos E. Lack of orthostatic symptoms in dementia patients with orthostatic hypotension. Clin Auton Res 25(2):87-94, 2015.
3. Freidenberg DL, Shaffer LE, Macalester S, Fannin EA. Orthostatic hypotension in patients with dementia: clinical features and response to treatment.Cogn Behav Neurol 26(3):105-120, 2013.
4. Saedon NI, Tan MP, Frith J. The prevalence of orthostatic hypotension: a systematic review and meta-analysis. J Gerontol A Biol Sci Med Sci, 2018. doi: 10.1093/gerona/gly188.
5. McKeith IG, Boeve BF, Dickson DW, Halliday G, Taylor JP, Weintraub D, et al. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology 89(1):88-100, 2017.
6. Udow SJ, Robertson AD, MacIntosh BJ, Espay AJ, Rowe JB, Lang AE, Masellis M. 'Under pressure': is there a link between orthostatic hypotension and cognitive impairment in alpha-synucleinopathies? J Neurol Neurosurg Psychiatry 87(12):1311-1321, 2016.
7. Postuma RB, Gagnon JF, Pelletier A, Montplaisir J. Prodromal autonomic symptoms and signs in Parkinson's disease and dementia with Lewy bodies. Mov Disord 28(5):597-604, 2013.
8. Claassen D, Adler C, Hewitt L, Gibbons C. Characterization of the symptoms of neurogenic orthostatic hypotension and their impact from a survey of patients and caregivers. BMC Neurol 18(1):125, 2018. doi: 10.1186/s12883-018-1129-x.
9. Juraschek SP, Daya N, Appel LJ, Miller ER, McEvoy JW, Matsushita K, et al. Orthostatic Hypotension and Risk of Clinical and Subclinical Cardiovascular Disease in Middle-Aged Adults. J Am Heart Assoc 7(10):e008884, 2018. doi:10.1161/JAHA.118.008884.
10. Mol A, Reijnierse EM, Hoang PTSB, van Wezel RJ, Meskers CG, Maier AB. Orthostatic hypotension and physical functioning in older adults: A systematic review and meta-analysis. Ageing Res Rev 48:122-144, 2018.
11. Ricci F, Fedorowski A, Radico F, Romanello M, Tatasciore A, Di Nicola M, et al. Cardiovascular morbidity and mortality related to orthostatic hypotension: a meta-analysis of prospective observational studies. Eur Heart J 36(25):1609-1617, 2015.
12. Oishi E, Sakata S, Tsuchihashi T, Tominaga M, Fujii K. Orthostatic Hypotension Predicts a Poor Prognosis in Elderly People with Dementia. Intern Med 55(15):1947-1952, 2016.
13. Kario K. Orthostatic hypertension-a new haemodynamic cardiovascular risk factor. Nat Rev Nephrol 9(12):726-738, 2013.
14. Frewen J, Savva G, Boyle G, Finucane C, Kenny R. Cognitive performance in orthostatic hypotension: findings from a nationally representative sample. J Am Geriatr Soc 62(1):117-122, 2014.
15. Torres R, Elias M, Crichton G, Dore G, Davey A. Systolic orthostatic hypotension is related to lowered cognitive function: Findings from the Maine-Syracuse Longitudinal Study. J Clin Hypertens 19(12):1357-1365, 2017.
16. Suemoto C, Baena C, Mill J, Santos I, Lotufo P, Benseñor I. Orthostatic hypotension and cognitive function: cross-sectional results from the ELSA-Brasil study. J Gerontol A Biol Sci Med Sci 74(3):358-365, 2019.
17. Guaraldi P, Poda R, Calandra-Buonaura G, Solieri L, Sambati L, Gallassi R, Cortelli P. Executive Functions Worsen during Orthostatic Challenge in Patients with Neurogenic Orthostatic Hypotension. Neurology 80(7):03-035, 2013.
18. Frewen J, Finucane C, Savv G, Boyle G, Kenny R. Orthostatic hypotension is associated with lower cognitive performance in adults aged 50 plus with supine hypertension. J Gerontol A Biol Sci Med Sci 69(7):878-885, 2013.
19. Foster-Dingley JC, Moonen JE, de Ruijter W, van der Mast RC, van der Grond J. Orthostatic hypotension in older persons is not associated with cognitive functioning, features of cerebral damage or cerebral blood flow. J Hypertens 36(5):1201-1206, 2018.
20. Peters R, Anstey K, Booth A, Beckett N, Warwick J, Antikainen R, et al. Orthostatic hypotension and symptomatic subclinical orthostatic hypotension increase risk of cognitive impairment: an integrated evidence review and analysis of a large older adult hypertensive cohort. Eur Heart J 39(33):3135-3143, 2018.
21. Huang H, Zheng T, Liu F, Wu Z, Liang H, Wang S. Orthostatic Hypotension Predicts Cognitive Impairment in the Elderly: Findings from a Cohort Study. Front Neurol 8:121, 2017.
22. McNicholas T, Tobin K, Carey D, O'Callaghan S, Kenny R. Is Baseline Orthostatic Hypotension Associated with a Decline in Global Cognitive Performance at 4-Year Follow-Up? Data from TILDA (The Irish Longitudinal Study on Ageing). J Am Heart Assoc 7(19):e008976, 2018.
23. Curreri C, Giantin V, Veronese N, Trevisan C, Sartori L, Musacchio E, et al. Orthostatic changes in blood pressure and cognitive status in the elderly: the Progetto Veneto Anziani Study. Hypertension 68(2):427-435, 2016.
24. Feeney J, Leary N, Kenny RA. Impaired orthostatic blood pressure recovery and cognitive performance at two-year follow up in older adults: The Irish Longitudinal Study on Ageing. Clin Auton Res 26(2):127-133, 2016.
25. Elmståhl S, Widerström E. Orthostatic intolerance predicts mild cognitive impairment: incidence of mild cognitive impairment and dementia from the Swedish general population cohort Good Aging in Skåne. Clin Interv Aging 9:1993-2002, 2014.
26. Bocti C, Pépin F, Tétreault M, Cossette P, Langlois F, Imbeault H, et al. Orthostatic hypotension associated with executive dysfunction in mild cognitive impairment. J Neurol Sci 382:79-83, 2017.
27. Hayakawa T, McGarrigle C, Coen R, Soraghan C, Foran T, Lawlor B, Kenny R. Orthostatic Blood Pressure Behavior in People with Mild Cognitive Impairment Predicts Conversion to Dementia. J Am Geriatr Soc 63(9):1868-1873, 2015.
28. Rawlings A, Juraschek S, Heiss G, Hughes T, Meyer M, Selvin E, et al. Association of orthostatic hypotension with incident dementia, stroke, and cognitive decline. Neurology 91(8):e759-e768, 2018.
29. Holm H, Nägga K, Nilsson E, Melander O, Minthon L, Bachus E, et al. Longitudinal and postural changes of blood pressure predict dementia: the Malmö Preventive Project. Eur J Epidemiol 32(4):327-336, 2017.
30. O'Hare C, Kenny RA, Aizenstein H, Boudreau R, Newman A, Launer L, et al. Cognitive Status, Gray Matter Atrophy, and Lower Orthostatic Blood Pressure in Older Adults. J Alzheimer's Dis 57(4):1239-1250, 2017.
31. Cremer A, Soumaré A, Berr C, Dartigues J, Gabelle A, Gosse P, Tzourio C. Orthostatic Hypotension and Risk of Incident Dementia: Results From a 12-Year Follow-Up of the Three-City Study Cohort. Hypertension 70(1):44-49, 2018.
32. Wolters FJ, Mattace-Raso FU, Koudstaal PJ, Hofman A, Ikram MA, & Heart Brain Connection Collaborative Research Group. Orthostatic Hypotension and the Long-Term Risk of Dementia: A Population-Based Study. PLoS Med 13(10):e1002143, 2016.
33. Ong H, Abdin E, Seow E, Pang S, Sagayadevan V, Chang S, et al. Prevalence and associative factors of orthostatic hypotension in older adults: Results from the Well-being of the Singapore Elderly (WiSE) study. Arch Gerontol Geriatr 72:146-152, 2017.
34. Soennesyn H, Dalen I, Aarsland D. Persistence and Prognostic Implications of Orthostatic Hypotension in Older Individuals with Mild-to-Moderate Dementia. Dement Geriatr Cogn Dis Extra 4(2):283-296, 2014.
35. Robertson AD, Messner MA, Shirzadi Z, Kleiner-Fisman G, Lee J, Hopyan J, et al. Orthostatic hypotension, cerebral hypoperfusion, and visuospatial deficits in Lewy body disorders. Parkinsonism Relat Disord 22:80-86, 2016.
36. Kimmerly DS, O'leary DD, Menon RS, Gati JS, Shoemaker JK. Cortical regions associated with autonomic cardiovascular regulation during lower body negative pressure in humans. J Physiol 569(1):331-345, 2005.

 
 
 
 
 
 
 
 
 
 
 
 
Está expresamente prohibida la redistribución y la redifusión de todo o parte de los contenidos de la Sociedad Iberoamericana de Información Científica (SIIC) S.A. sin previo y expreso consentimiento de SIIC.
ua31618
Bienvenidos a siicsalud

Copyright siicsalud © 1997-2024 ISSN siicsalud: 1667-9008