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Christina Lau, 23 Nov 2018

In patients with severe small vessel disease (SVD), intensive blood pressure (BP) lowering does not reduce cerebral perfusion or increase the risk of falls, according to results of the ASL substudy of the PRESERVE trial.

Congenital heart disease ups risk of dementia

15 Feb 2018
In 2015, it was estimated that, there were close to 47 million people worldwide suffering from dementia – and the number is likely to go up to more than 131 million by 2050.

Persons with congenital heart disease (CHD) are at a higher risk of dementia, particularly early-onset dementia, than the general population, a recent study has shown.

Researchers accessed the medical records of 10,632 adults with CHD (46 percent male) and compared each patient with 10 age- and sex-matched controls from the general population. The cumulative incidence of dementia by 80 years of age in both cohorts was 4 percent (n=1,072).

Analysis by cohort showed that there were 95 and 977 cases of dementia in the CHD and control groups, respectively. This translated to a significantly higher risk of all-cause dementia in those with CHD (hazard ratio [HR], 1.61; 95 percent CI, 1.29–2.02).

The trend remained significant even when analysed according to different types of dementia: Alzheimer’s disease (22 vs 246 cases; HR, 1.35; 0.86–2.15), vascular dementia (11 vs 107 cases; HR, 1.62; 0.84–3.11) and other dementias (62 vs 624 cases; HR, 1.73; 1.30–2.30).

Analysis by patient subgroup likewise did not significantly alter the results. Risk elevation was similar for male (HR, 1.55; 1.06–2.26) and female (HR, 1.65; 1.25–2.19) CHD patients.

The risk seemed to increase with CHD severity. Those with mild-to-moderate CHD (HR, 1.50; 1.14–1.97) had lower risks of dementia relative to those with severe and univentricular CHD (HR, 1.96; 1.15–3.34). The risk for those with unclassified CHD severity was also elevated (HR, 1.85; 1.01–3.40).

Subsequent sensitivity analyses, such as exclusion of all individuals with mild cognitive impairments and amnestic syndromes, did not significantly change the results.

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Most Read Articles
Christina Lau, 23 Nov 2018

In patients with severe small vessel disease (SVD), intensive blood pressure (BP) lowering does not reduce cerebral perfusion or increase the risk of falls, according to results of the ASL substudy of the PRESERVE trial.