Revista Argentina de Cardiología · Feb 27, 2026
Arterial hypertension and cognitive impairment in the elderly
By Weissmann P, Consalvo D, Solis PCL et al.
The elderly population is at high risk for developing cerebral, cardiac, and vascular complications. Neurocognitive integrity is vital for elderly people to maintain their independence, and any factor that could be identified as a potential contributor to cognitive impairment warrants careful investigation. Recently, whether blood pressure (BP) independently contributes to the cognitive impairment that accompanies aging has been a subject of debate. Arterial hypertension has been associated with atherosclerotic changes in large and small cerebral arteries, with reduced autoregulation of cerebral blood flow, and with the main risk factors for the development of stroke and multi-infarct dementia. It is also important to emphasize that recently, magnetic resonance imaging has revealed the presence of silent lesions of the periventricular cerebral white matter as well as lacunar infarcts in hypertensive subjects and older adults, and this may be associated with impaired cognitive function. Substantial evidence has accumulated regarding vascular mechanisms and also vascular pathology as a possible trigger of cognitive impairment and dementia in the elderly. This article provides an update on the importance of identifying factors responsible for cognitive impairment in elderly hypertensive patients.