Kotlyarov SN. Mechanisms of cognitive impairment in arterial hypertension. World J Psychiatry 2025; 15(7): 106597 [DOI: 10.5498/wjp.v15.i7.106597]
Corresponding Author of This Article
Stanislav Nikolaevich Kotlyarov, PhD, Professor, Department of Nurse, Ryazan State Medical University, 9 Vysokovoltnaya, Ryazan 390005, Russia. skmr1@yandex.ru
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatry. Jul 19, 2025; 15(7): 106597 Published online Jul 19, 2025. doi: 10.5498/wjp.v15.i7.106597
Mechanisms of cognitive impairment in arterial hypertension
Stanislav Nikolaevich Kotlyarov
Stanislav Nikolaevich Kotlyarov, Department of Nurse, Ryazan State Medical University, Ryazan 390005, Russia
Author contributions: Kotlyarov SN contributed to the conceptualization, methodology, validation, resources, data curation, writing of the original draft, review and editing, supervision, and project administration.
Conflict-of-interest statement: The author has no conflicts of interest to declare.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Stanislav Nikolaevich Kotlyarov, PhD, Professor, Department of Nurse, Ryazan State Medical University, 9 Vysokovoltnaya, Ryazan 390005, Russia. skmr1@yandex.ru
Received: March 3, 2025 Revised: March 21, 2025 Accepted: April 7, 2025 Published online: July 19, 2025 Processing time: 130 Days and 13.8 Hours
Abstract
Cognitive impairment in elderly patients with arterial hypertension is an urgent medical and social problem. This is especially important given the high prevalence of arterial hypertension. In this regard, the mechanisms of cognitive impairment are of growing interest in order to find new preventive and therapeutic strategies. In general, the main mechanisms determining the association between hypertension and cognitive impairment include imbalances in cerebral blood flow perfusion, immune and metabolic disorders, blood-brain barrier dysfunction, and brain structure abnormalities. Metabolic disorders, including insulin resistance in the brain, are of growing interest as mechanisms of cognitive impairment. Comorbid diseases and target organ damage, which are common in arterial hypertension, also play an important role.
Core Tip: Arterial hypertension contributes to the development of cognitive impairment through several direct and indirect mechanisms involving hemodynamic, structural, immune, and metabolic abnormalities. There is a U-shaped relationship between blood pressure and the risk of cognitive impairment; that is, both high and low blood pressure can contribute to hemodynamic disturbances in the brain and its structural and functional impairments. Target organ damage in arterial hypertension and comorbidities, including metabolic disorders, are important for the development of cognitive impairment. In this regard, correction of risk factors and maintenance of blood pressure in the target range may be useful for the prevention of cognitive impairment.
