Vascular dementia is characterized by psychomotor slowing, reduced attention, early loss of executive function and personality changes. On CT scans and MRIs it is seen as areas of small cerebral infarcts in the cerebral vessels affected by atherosclerosis, a process that can be initiated and accelerated by hypertension.

Alzheimer’s disease is another form of dementia that is believed to be associated with hypertension. In many instances it is seen in conjunction with vascular dementia, and the two may share some of the pathological mechanisms responsible for their development. While there are other factors influencing the development of particular disease (age and genetic factors being the most important), Alzheimer’s is increasing in incidence in patients suffering from hypertension as adults in their 40s and 50s.

A study published in the Neurology Journal in 2002 evaluated the relationship of hypertension in the elderly to the development of AD as well as vascular dementia. Among the 1,259 patients with hypertension analyzed in a 7-year study, hypertension was associated with development of vascular dementia, but no link towards development of Alzheimer’s was found. The presence of heart disease and diabetes compounded the risk for vascular dementia.

An important study published in the Archives of Internal Medicine Journal in 2002 looked at the development of dementia among two groups of patients – one receiving antihypertensive medication for their high blood pressure as well as a group receiving placebo medication. Over 2,900 patients were included in this study. Blood pressures were higher by an average of 7 mm Hg (a relatively small number) in the group not receiving medication.

The results showed that the group receiving the antihypertensive medication had an incredible 55 % decrease in the diagnosis of dementia as compared to the control group. This particular study showed a clear protective effect of antihypertensive drugs on the development of dementia. In this particular study, both vascular dementia and Alzheimer’s incidence was decreased. The medication used in the study was the calcium-channel blocker nitrendipine and there are several reports indicating that calcium-channel blockers may confer specific neuroprotection not available with other antihypertensive agents.