Pathophysiological mechanisms in the relationship between cardiovascular disease and cognitive impairment
Keywords:
Alzheimer disease, atrial fibrillation, carotid stenosis, cerebral infarction, dementia, heart failureAbstract
Introduction: Dementia and cardiovascular diseases (CVD) are prevalent conditions in the elderly population, with a complex and multifactorial relationship. Recent studies suggest that cardiovascular diseases may contribute to cognitive decline and dementia.
Objective: To describe current evidence on the causal relationship between cardiovascular diseases and cognitive impairment, highlighting pathophysiological mechanisms and clinical implications.
Method: A narrative review of the literature was conducted based on a structured search in Medline (via PubMed), SciELO, Cochrane Library, and Google Scholar for studies published between 2018 and 2024. The search strategy incorporated terms such as 'Dementia,' 'Cognitive Dysfunction,' 'Cardiovascular Diseases,' and their Spanish equivalents, combined with Boolean operators. The selection of studies focused on identifying the most relevant evidence discussing pathophysiological mechanisms and clinical implications.
Development: Epidemiological evidence shows an association between CVD (coronary heart disease, heart failure, atrial fibrillation, and stroke) and dementia. Mechanisms such as cerebral hypoperfusion, silent microinfarcts, and endothelial dysfunction explain this relationship. Additionally, factors like hypertension and diabetes mellitus are common to both conditions.
Conclusions: The evidence confirms that the relationship between cardiovascular diseases and dementia is causal, mediated by mechanisms of cerebral hypoperfusion, silent microinfarcts, and endothelial dysfunction. This knowledge supports the association of cardiovascular health as a cornerstone in the prevention of cognitive impairment. Further studies are needed to validate specific interventions targeting these mechanisms.
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