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Opinion EDITORIAL Philip B. Gorelick, MD, MPH Hypertension affects more than two-thirds of US adults cluding the Delayed Word Recall Test for assessing verbal learn- 60 years or older, and control is considered by some to be the ing and short-term memory, the Digit Symbol Substitution Test “crown jewel” of stroke prevention. Despite mounting epide- for evaluating executive function and processing speed, and miologic and mechanistic evidence linking raised blood the Word Fluency Test for assessing executive function and ex- pressure (BP) to cognitive pressive language. The study instruments are reasonable tools decline or dementia, uncer- for detection of vascular processes that might affect the brain Related article page 1218 tainty remains about the ben- and cause executive dysfunction or impairment of psycho- efit of loweringBPtoprevent motor speed and AD that might impair memory. The mean 2,3 cognitive impairment. Recent estimates suggest, for ex- z scores for each cognitive test were calculated to develop a ample, that 8% of cases of Alzheimer disease (AD) may be at- global cognition z score. tributable to midlife hypertension, and the relative risk for Measurement of BP was standardized using a zero sphyg- midlife hypertension in AD is 1.6. Furthermore, multiple po- momanometer.
JAMA Neurology – American Medical Association
Published: Oct 1, 2014
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