Biomedical subjects

M L Seux

Publications and source records attributed to M L Seux.

At least 19 recordsLinked to original sources

PubMed2005

[Cognitive functions and hypertension].

The prevention of cognitive disorders and dementia represents a major challenge in the coming years. Hypertension is one of the principal risk factors for cerebrovascular diseases and is also closely correlated with cognitive decline and dementia. Most longitudinal studies have shown that cognitive functioning is often inversely proportional to blood pressure values measured 15 or 20 years previously. The higher blood pressure was, the poorer cognitive function is. Data from recent therapeutic trials (SYST-EUR, PROGRESS) open the way toward the prevention of dementia (vascular or Alzheimer's type) by antihypertensive treatments. In this context, the effect of antihypertensive treatment on cognitive functions should represent one of the primary criteria of assessment in future morbidity and mortality studies in hypertensive patients.

Antihypertensive Agents↗

PubMed2003

Donepezil for the treatment of mild to moderate Alzheimer's disease in France: the economic implications.

In the present study, the socioeconomic impact of the use of the acetylcholinesterase inhibitor donepezil in patients with mild to moderate Alzheimer's disease (AD) living in France was examined. A model was created to extrapolate over a 3-year period the results from placebo-controlled trials together with epidemiological and prevalence data. Costs considered in the model were net societal costs associated with paid and unpaid assistance, general medical consumption and institutional care. The model suggested that delays in cognitive decline and functional dependence due to treatment reduced the time spent in institutional care and the burden on caregivers. Over a 3-year period, total net costs of caring for untreated patients with an initial Mini-Mental State Examination score ranging from 10 to 26 were EUR 53,206 compared with EUR 42,720 for a patient treated with donepezil--an annual cost saving of approximately EUR 3,500 per patient. Cost savings were mainly due to savings in unpaid caregiver time, which, apart from patient institutionalization, represented the most costly component of total care in this study but had no direct budgetary impact. Overall, these data suggest that donepezil is a cost-effective treatment for mild to moderately impaired AD patients living in France.

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PubMed2003

[Relationship between arterial pressure and cognitive functions. Data for the French Network on Alzheimer's disease (REAL.FR)].

UNLABELLED: The relationships between arterial hypertension and cognitive decline are complex and studies indicate controversial results. OBJECTIVES: To evaluate, in a cross sectional study, the relationships between cognitive functions and blood pressure in a population of subjects with Alzheimer's disease. METHODS: In 520 subjects of a survey in a French population with Alzheimer's disease, relationships between the severity of cognitive decline and a history of hypertension or blood pressure level have been searched. Cognitive functioning was assessed with validated neuropsychological tests evaluating cognitive functions and the capacities in the activities of daily living (Mini Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale--Cognitive part (ADAS-Cog), Instrumental Activities of Daily Living (IADL), Activities of Daily Living (ADL), Clinical Dementia Rating (CDR), Global Deterioration Scale (GDS) of Reisberg). In 456 subjects blood pressure was measured during the consultation. RESULTS: The results indicate that after adjustment on age, sex, education level, and the other cardiovascular risk factors, subjects with a history of hypertension have a more marked cognitive decline than subjects without history of hypertension. Indeed, in subjects with a history of hypertension, the cognitive impairment and its consequences on activities of daily living are more important than in subjects without history of hypertension (ADAS-cog 19.02 +/- 8.48 vs 17.49 +/- 8.53 p = 0.06, MMSE 19.55 +/- 4.41 vs 20.30 +/- 4.42, p = 0.08, score ADL 5.31 +/- 0.86 vs 5.51 +/- 0.87, p = 0.01, CDR 6.94 +/- 3.29 vs 6.19 +/- 3.26 p = 0.03; global CDR 1.18 +/- 0.62 vs 1.05 +/- 0.60, p = 0.03, GDS of Reisberg 4.41 +/- 0.74 vs 4.27 +/- 0.75, p = 0.05). In contrast, no relation between blood pressure measurements and cognitive function is observed, and moreover an inverse correlation between blood pressure and consequences on activities of daily living is found. CONCLUSIONS: This work indicates that relationships between blood pressure and cognitive functions are more complex than a simple linear relation. The present results show that a history of arterial hypertension is associated with a more marked cognitive decline in subjects with Alzheimer's disease. In contrast, when the Alzheimer's disease is already developed no relation between blood pressure and cognitive functions appears and moreover an inverse correlation with the consequences on activities of daily living is found.

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PubMed2003

[Cognitive decline and hypertension].

The prevalence and incidence of degenerative and vascular dementia increase exponentially with age. Several studies in recent years have implicated hypertension as a risk factor not only for vascular dementia but also for degenerative dementia such as Alzheimer's disease. This is an important finding because it suggests that the treatment of hypertension could reduce the incidence of dementia. In particular, the results of the Syst-Eur study, showing that a calcium inhibitor, nitrendipine, could reduce not only the incidence of stroke but also that of dementia, should be confirmed.

Adult↗

PubMed2001

Blood pressure, cognitive functions, and prevention of dementias in older patients with hypertension.

The prevalence and incidence of degenerative and vascular dementias increase exponentially with age, from 70 years onward. In view of the increasing longevity of humans, both varieties are bound to evolve into a major problem worldwide. According to several longitudinal studies, hypertension appears to predispose individuals to the development of cognitive impairment and ensuing dementia, after a period varying from a few years to several decades. Antihypertensive drug treatment, according to preliminary evidence, may serve to reduce the rates of such events. Such findings await to be confirmed by formal therapeutic trials against a backdrop of "historical" observational sources.

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PubMed2001

Hypertension and dementia.

The increase in life expectancy is associated with a sharp rise in cognitive disorders, particularly after the age of 80 years. The identification and management of risk factors for these invalidating and distressing conditions must be considered a priority. The fact that antihypertensive treatment has been demonstrated to decrease that risk offers a new opportunity to reduce the prevalence of such related disorders and promote healthy aging.

Antihypertensive Agents↗

PubMed2000

[Cognitive impairment and dementia in hypertension; the effect of antihypertensive medication].

The prevalence and incidence of both degenerative (Alzheimer) and vascular dementias rise exponentially with aging. In both forms of dementia hypertension is a predisposing factor. The interval between the onset of hypertension and the manifestation of dementia amounts to 12-15 years. A complicating factor is the observation that initial dementia may be accompanied by secondary decrease in blood pressure. A preventive effect of current antihypertensive treatment is likely, according to preliminary evidence (particularly with regard to the use of the calcium antagonist nitrendipine), but the hopeful perspective of protection against dementias through antihypertensive treatment remains to be confirmed by further prospective comparative trials.

Antihypertensive Agents↗

PubMed2000

Does the benefit of antihypertensive treatment outweigh the risk in very elderly hypertensive patients?

The risk of hypertension and the benefits of antihypertensive treatment are well established in older patients aged up to 80 years. For people aged 85 and over, data are scarce and conflicting. A positive association between blood pressure and survival has been found in several cohort studies; this relationship held true after adjustment for many factors in some studies, but disappeared after adjustment for indicators of poor health in others. In randomized trials, the benefit of antihypertensive treatment was demonstrated in the Systolic Hypertension in the Elderly Program (SHEP) study, but it declined with age and was not observable after 80 years in the European Working Party on High Blood Pressure in the Elderly (EWPHE) study. The SYSTolic hypertension in elderly in EURope Trial (SYST-EUR) study evidenced a benefit on cardiovascular morbidity but not on mortality. People who reach a very old age share some characteristics that make them different from those '60 (or 65) and over' and justify special studies which are currently in progress. In the meantime, any treatment decision can only rely on extrapolations moderated by common sense, but the already demonstrated favorable results on morbidity argue against a threshold beyond which hypertension should not be treated.

Age Factors↗

PubMed1999

Effects of hypertension and its treatment on mental function.

This paper addresses the relationship between hypertension and cognitive status and the impact of antihypertensive treatment. Data from cross-sectional and longitudinal studies are reviewed. After adjustment for age and level of education, cognitive function of hypertensive patients is impaired compared with the cognitive status of their nonhypertensive counterparts. The mechanisms underlying hypertension associated cognitive impairment remain to be elucidated. The role of antihypertensive treatment also has to be determined. Some evidence suggests that antihypertensive treatment may prevent dementia in hypertensive patients.

Antihypertensive Agents↗

PubMed1999

Systolic Hypertension in Europe (Syst-Eur) trial phase 2: objectives, protocol, and initial progress. Systolic Hypertension in Europe Investigators.

The Systolic Hypertension in Europe (Syst-Eur) trial proved that blood pressure (BP) lowering therapy starting with nitrendipine reduces the risk of cardiovascular complications in older (> or = 60 years) patients with isolated systolic hypertension (systolic BP > or = 160 mm Hg and diastolic BP < 95 mm Hg). After the completion of the Syst-Eur trial on 14 February 1997, 3506 consenting patients (93.0% of those eligible) were enrolled in phase 2 of the Syst-Eur trial. This open follow-up study aims to confirm the safety of long-term antihypertensive therapy based on a dihydropyridine. To lower the sitting systolic BP below 150 mm Hg (target BP), the first-line agent nitrendipine (10-40 mg/day) may be associated with enalapril (5-20 mg/day), hydrochlorothiazide (12.5-25 mg/day), both add-on study drugs, or if required any other antihypertensive agent. On 1 November 1998, 3248 patients were still being followed, 86 patients had proceeded to non-supervised follow-up, and 43 had died. The median follow-up in Syst-Eur 2 was 14.3 months. At the last available visit, systolic/diastolic BP in the patients formerly randomised to placebo (n = 1682) or active treatment (n = 1824), had decreased by 13.2/5.2 mm Hg and by 4.6/1.6 mm Hg, respectively, so that the between-group BP difference was 1.7 mm Hg systolic (95% Ci: 0.8 to 2.6 mm Hg; P < 0.001) and 0.9 mm Hg diastolic (95% Cl: 0.4 to 1.5 mm mm Hg; P < 0.001). At the beginning of Syst-Eur 2, the goal BP was reached by 25.4% and 50.6% of the former placebo and active-treatment groups; at the last visit these proportions were 55.9% and 63.1%, respectively. At that moment, 45.9% of the patients were on monotherapy with nitrendipine, 29.3% took nitrendipine in combination with other study drugs. Until the end of 2001, BP control of the Syst-Eur 2 patients will be further improved. Cardiovascular complications and adverse events, such as cancer or gastro-intestinal bleeding, will be monitored and validated by blinded experts.

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PubMed1999

[Treatment of isolated systolic arterial hypertension and prevention of dementia in aged patients. The Syst-Eur multicenter study].

UNLABELLED: The aim of the vascular dementia project, set up in the framework of the double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial, was to investigate the influence of antihypertensive drug treatment on the incidence of vascular dementia. The study was run on non-demented patients, at least 60 years old, with isolated systolic hypertension (sitting blood pressure of 160-219 mmHg for systolic and below 95 mmHg for diastolic). Treatment was initiated with nitrendipine (10-40 mg/day) possibly associated with enalapril (5-20 mg/day) and/or hydrochlorothiazide (12.5-25 mg/day). Cognitive function was assessed at baseline and annually by the Mini Mental State Examination (MMSE). The diagnosis of dementia was based on the DSM-III-R criteria. The etiology of dementia was established using the Modified Ischemic Score or the Hachinski score when brain imaging was not available. Median follow-up by intention-to-treat was 2.0 years. The incidence of dementia was reduced by 50% from 7.7 per 1000 patient-years in the placebo group (number of patients 1,180) to 3.7 cases per 1000 p-a in the active treatment group (n = 1,238) (21 vs 11 patients, p = 0.05). At the last available evaluation, systolic and diastolic blood pressure were 8.3 mmHg and 3.8 mm Hg lower (p < or = 0.001) in the active-treatment group, but on average the MMSE scores remained stable in both groups. CONCLUSION: In older people with isolated systolic hypertension, antihypertensive treatment started with nitrendipine may reduce the incidence of dementia. At the rate observed in the placebo group, treating 1,000 patients for 5 years would prevent 19 cases of dementia.

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PubMed1999

[Arterial hypertension of the aged patient in general medicine. French national survey].

The aim of the study was to assess the management of elderly hypertensives in general practice. A sample of 2,727 general practitioners filled a specially designed questionnaire between February and March 1998 in France. Areas covered by the questionnaire included risk of hypertension, blood pressure measurement and treatment. Most respondents (97%) considered that hypertension remains a cardiovascular risk factor in elderly but 4% thought that hypertension is usefull by improving target organ perfusion. Fifty-five percent recorded both standing and supine measurement, 34% reported measuring blood pressure with patient supine only. All respondents reported that they would start antihypertensive treatment on the basis of blood pressure level. A minimum systolic level of 160 and 180 mmHg was given by 65% and 27% practitioners respectively while 2% required a minimum level ranging from 139 to 149 mmHg. Among the respondents who considered that isolated systolic hypertension is pathological (74%), 73% and 19% used 160 and 180 mmHg as cut-off, respectively. Among those who considered that isolated systolic hypertension is physiological (23%), 43% and 46% initiated treatment above 160 and 180 mmHg, respectively. A minimum diastolic level of 90 mmHg was reported by many respondents (61%) while 34% required a cut-off level of 100 mmHg. Comparison of systolic and diastolic levels showed that 49% practitioners started antihypertensive therapy above 160/90 mmHg and 16% above 180/100 mmHg. Less than 1% reported a threshold level of 140/90 mmHg. Most practitioners 5%) treated hypertensive patients regardless of their age. The others treated patients younger than 65 years old (3%), 70 (2%), 80 (5%) and 90 (4%). All respondents reported that they would treat their patients to prevent vascular complications, mainly cerebrovascular (96%), cardiac (89%) and kidney (75%) disease. In conclusion, for all general practitioners, hypertension remains a cardiovascular risk factor in elderly and hypertensive therapy is beneficial to prevent cardiovascular complications. This study reveals some inter-physician variability in blood pressure measurement and treatment. The risk of standing blood pressure fall is not taken into account by 66% of respondents. Variability in age threshold is in accordance with the lack of published data on benefice of hypertensive treatment in the very old. The risk of isolated systolic hypertension is under-estimated by 27% of physicians who reported a minimum systolic blood pressure level of 180 mmHg to initiate therapy.

Adult↗

PubMed1999

[Antihypertensive treatment and prevention of dementia].

Hypertension is a risk factor for dementia, particularly vascular dementia. The objective of the "Vascular Dementia" project of the European multicentre Syst-Eur trial was to study the influence of antihypertensive therapy on the incidence of dementia in elderly patients with isolated systolic hypertension included in this trial. Patients were over the age of 60, with systolic blood pressure between 160 and 219 mmHg and diastolic blood pressure less than 95 mmHg in the sitting position and were not demented. After randomization, they were treated under double-blind conditions with nitrendipine associated with or replaced by enalapril or hydrochlorothiazide or an equivalent placebo. Cognitive functions were evaluated by the Mini-Mental State test (MMS) on inclusion then annually. When the MMS score was < or = 23, a complementary assessment was performed to establish the diagnosis of dementia according to DSM III-R criteria. The Modified Ischaemia score specified the aetiology of dementia. A total of 1180 and 1238 subjects were randomized to the placebo and active treatment groups, respectively. They presented comparable characteristics on inclusion. The median intent to treat duration of follow-up was 2.0 years. The incidence of dementia was decreased by 50%, from 7.7 per thousand patient-years in the placebo group to 3.8 per thousand patient-years in the active group (p = 0.05). There were 15 and 8 cases of dementia of the Alzheimer type, 4 and 3 cases of mixed dementia, 2 and 0 cases of vascular dementia in the placebo and active treatment groups, respectively. In conclusion, in subjects over the age of 60 years with isolated systolic HT, antihypertensive treatment initiated with nitrendipine can reduce the incidence of dementia.

Age Factors↗

PubMed1998

Prevention of dementia in randomised double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial.

BACKGROUND: Systolic hypertension increases the risk of dementia in elderly people. The vascular dementia project, set up in the framework of the double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial, investigated whether antihypertensive drug treatment could reduce the incidence of dementia. METHODS: Eligible patients had no dementia, were at least 60 years old, and had a blood pressure when seated of 160-219 mm Hg systolic and below 95 mm Hg diastolic. Active treatment consisted of nitrendipine (10-40 mg/day) with the possible addition of enalapril (5-20 mg/day), hydrochlorothiazide (12.5-25 mg/day), or both drugs, titrated or combined to reduce the systolic blood pressure by at least 20 mm Hg to reach a value below 150 mm Hg. Cognitive function was assessed by the mini mental state examination (MMSE). If the MMSE score was 23 or less, diagnostic tests for dementia were done (DSM-III-R criteria). The cause of dementia was established by the modified ischaemic score with brain imaging or the Hachinski score. FINDINGS: Median follow-up by intention to treat was 2.0 years. Compared with placebo (n=1180), active treatment (n=1238) reduced the incidence of dementia by 50% from 7.7 to 3.8 cases per 1000 patient-years (21 vs 11 patients, p=0.05). The median MMSE score at randomisation was 29 in both treatment groups. At the last available assessment, systolic and diastolic blood pressure were, respectively, 8.3 mm Hg and 3.8 mm Hg lower (p<0.001) in the active-treatment group, but on average the MMSE scores did not change in either group. In the control patients, however, the MMSE decreased (p=0.04) with decreasing diastolic blood pressure, whereas in the active-treatment group MMSE scores improved slightly (p=0.01) with greater reduction in diastolic blood pressure (p=0.002 for between-group difference). INTERPRETATION: In elderly people with isolated systolic hypertension, antihypertensive treatment was associated with a lower incidence of dementia. If 1000 hypertensive patients were treated with antihypertensive drugs for 5 years 19 cases of dementia might be prevented.

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PubMed1998

Correlates of cognitive status of old patients with isolated systolic hypertension: the Syst-Eur Vascular Dementia Project.

OBJECTIVE: To assess cognitive functions and their correlates for a dementia-free cohort of old patients with isolated systolic hypertension. DESIGN: Cross-sectional data from the randomization period of the European Trial in Elderly with Systolic Hypertension (Syst-Eur Vascular Dementia Project). SETTING: Sixteen European countries and Israel. PARTICIPANTS: We studied 2252 patients aged 60-100 years (mean 70). MAIN OUTCOME MEASURES: Mini Mental State Examination (MMSE) and Spearman correlation of MMSE scores to demographic data or blood pressure. RESULTS: The MMSE was successfully completed for 1474 women and 751 men. The baseline blood pressure averaged 173 +/- 10/86 +/- 6 mmHg (means +/- SD). Median age at which education of patients at school had stopped was 15 years. Men and women who consumed alcohol (28%) had median intakes of 8 and 3 g/day, respectively. The median MMSE score was 29 (range 15-30). The maximum score of 30 was attained by 609 (30%) subjects. Fifty-nine (3%) patients had a MMSE score of 23 or less. The MMSE score decreased with advancing age (r = -0.21, P < 0.001). Both for men and for women, it was positively correlated to the level of education (r = 0.30 and r = 0.32, P < 0.001). For women after adjustment for age and the level of education, the score was correlated negatively to systolic blood pressure (r = -0.07, P < 0.05) but positively to intake of alcohol (r = 0.06, P < 0.05). CONCLUSION: In a cohort of elderly patients with isolated systolic hypertension, baseline cognitive function measured in terms of the MMSE score was high, probably due to selective recruitment of patients who were not clinically demented. Blood pressure was a weak contributor to cognitive status compared with age and level of education. Baseline cognitive function of women was negatively and independently correlated to systolic blood pressure.

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PubMed1998

Detection of cerebral aging, an absolute need: predictive value of cognitive status.

Cognitive performance is predictive of functional status, morbidity and mortality in the elderly. In the SYST-EUR study, the Vascular Dementia Project run on 3,111 subjects 60 years old and over, with isolated systolic hypertension, has shown that the cognitive status as measured by the MMSE was inversely correlated with systolic blood pressure (p < 0.001) and age (p < 0.001) and positively correlated with the level of education (p < 0.001). It is significantly lower in patients with cardiovascular complications (p = 0.0001). Moderate alcohol consumption is linked to a higher MMSE score in women (p < 0.001) but not in men. In this study, the incidence of dementia is low and significantly related to the baseline value of the MMSE score and further analysis will show the influence of the treatment of systolic hypertension with calcium antagonists as first step on this incidence.

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PubMed1998

Calcium channel blockade and cardiovascular prognosis in the European trial on isolated systolic hypertension.

In the double-blind Systolic Hypertension in Europe (Syst-Eur) Trial, active treatment was initiated with nitrendipine (10 to 40 mg/d) with the possible addition of enalapril (5 to 20 mg/d) and/or hydrochlorothiazide (12.5 to 25 mg/d) titrated or combined to reduce sitting systolic blood pressure by at least 20 mm Hg to <150 mm Hg. In the control group, matching placebos were used similarly. In view of persistent concerns about the use of calcium channel blockers as first-line antihypertensive drugs, this report explored to what extent nitrendipine, administered alone, prevented cardiovascular complications. Age at randomization averaged 70.2 years and systolic/diastolic blood pressure 173.8/85.5 mm Hg. Of 2398 actively treated patients, 1327 took only nitrendipine (average dose, 23.4 mg/d), and 1042 progressed to other treatments including nitrendipine (n=757; 35.7 mg/d), enalapril (n=783; 13.4 mg/d), and/or hydrochlorothiazide (n=294; 21.0 mg/d). Compared with the whole placebo group (n=2297), patients receiving monotherapy with nitrendipine had 25% (P=0.05) fewer cardiovascular end points, and those progressing to other active treatments showed decreases (P</=0. 01) in total mortality (40%), stroke (59%), and all cardiovascular end points (39%). Among the control patients, 863 used only the first-line placebo. Compared with this subgroup, patients receiving monotherapy with nitrendipine showed a nearly 50% (P</=0.004) reduction of all types of end points, including total and cardiovascular mortality. The full relative benefit from nitrendipine was seen as early as 6 months after randomization. To ascertain that the benefit conferred by the dihydropyridine was not due to selection bias, the 1327 patients remaining on monotherapy with nitrendipine were matched by gender, age, previous cardiovascular complications, and systolic blood pressure at entry with an equal number of placebo patients. In this analysis, nitrendipine reduced (P</=0.05) cardiovascular mortality by 41%, all cardiovascular end points by 33%, and fatal and nonfatal cardiac end points by 33%. Despite the limitations inherent in post hoc analyses, the present findings suggest that the calcium channel blocker nitrendipine, given as a single antihypertensive medication, prevents cardiovascular complications in older patients with isolated systolic hypertension.

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PubMed1997

[Isolated systolic hypertension and cognitive function in the aged. Experience of the Syst-Eur study].

OBJECTIVE: To determinate cognitive status and its correlates in older patients with isolated systolic hypertension. METHODS: Syst-Eur is a double-blind placebo-controlled outcome trial conducted in European patients over 60 years of age with isolated systolic hypertension. Moreover, a side-project--the Vascular Dementia Project--is designed to assess cognitive functions and to follow-up their evolution to determine the influence of antihypertensive therapy on vascular dementia incidence. Cognitive functions were evaluated at entry with the MiniMental State Examination (MMSE) in 2250 patients included in Syst-Eur. Cognitive impairment was defined with a MMSE score < or = 23 and led to further evaluation. Baseline blood pressure (BP) was based on the average of six sitting blood pressure readings at three run-in visits 1 month apart. Statistical analysis used Spearman correlation. RESULTS: The MMSE was analysed in 1374 women and 751 men whose mean age was 70 years (range: 60-100). The median level of education expressed as the age at which they stopped their education at school, was 15 years. Baseline blood pressure averaged 173 +/- 10/86 +/- 6 mmHg. Before randomisation in the trial, 899 (40%) patients had received antihypertensive therapy and 602 (27%) had experienced cardiovascular complications. The MMSE-scores ranged from 15 to 30 (median = 29). The maximal score of 30 was reached by 609 (30%) subjects. Among the 59 (3%) patients with a MMSE-score of 23 or less, 5 were considered to be demented according to the DSM IIIR criteria. The MMSE-scores decreased with advancing age in men (r = -0.16; p < 0.001) and women alike (r = -0.24; p < 0.001). In both men and women, they were positively correlated with the level of education (r = 0.30 and 0.32, respectively; p < 0.001). They were negatively correlated with systolic blood pressure (r = 0.10; p < 0.001) and slightly positively correlated with diastolic blood pressure (r = 0.05; p = 0.03). Previously treated patients or patients reporting cardiovascular complications at baseline had lower MMSE-scores than their non-treated counterparts or subjects without cardiovascular complications (median = 28 and 29, respectively, p < 0.003). CONCLUSION: In a European cohort of 2225 patients over 60 years of age with isolated systolic hypertension, the level of cognitive functions evaluated with the MMSE decreases with advancing age or lesser educational level. It also decreases with higher systolic blood pressure or lower diastolic blood pressure. The influence of antihypertensive therapy on cognitive status will be prospectively evaluated in Syst-Eur Vascular Dementia Project.

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