Preventing Dementia by Treating Hypertension and Preventing Stroke

In this issue of Hypertension, Korf et al1 report from theHonolulu Asia Aging Study that untreated hypertensionwas significantly associated with hippocampal atrophy. They had previously shown that untreated hypertension was associated with midlife cognitive decline2 and with Alzhei-mer disease and vascular dementia.3 This new finding strengthens the value of hippocampal atrophy as an early predictor of cognitive decline. It also adds importantly to a growing body of evidence that hypertension and stroke beget dementia and that treatment of hypertension, as well as prevention of stroke, prevents dementia. In the past this might have been explained by a reduction of vascular dementia, but it is apparent that the lines between vascular dementia and Alzheimer disease are becoming blurred. Hypertension is strongly associated with the subsequent development of dementia. In Linxiang County, China, high blood pressure was shown in multiple logistic regression to