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Abstract(s)
A Hipertensão Arterial (HTA) afeta mais de dois terços da população mundial acima dos 60
anos e 16,5% da população mundial, com efeitos deletérios na saúde destes, especialmente
no que toca ao compromisso cognitivo de origem vascular (CCV) e doença de Alzheimer. Os
processos que levam à disfunção cognitiva são complexos e não estão completamente
elucidados.
A hipertensão arterial tem forte componente fisiopatológica e sinérgica com o
envelhecimento, diminuindo a homeostasia cerebral e a resiliência endotelial ao stress
oxidativo. A Hipertensão Arterial afeta a estrutura e a função cerebrovascular, com maior
dano na microcirculação, com processos tais como: rarefação microvascular, disfunções
endoteliais e da hiperemia funcional, e doença dos vasos pequenos.
O diágnostico precoce de compromisso cognitivo vascular pode ser realizado com técnicas
imagiológicas que identificam a doença dos pequenos vasos, por aumento de
hiperintesidade da matéria branca, enfartes lacunares e microhemorragias. Vários estudos
demonstraram o benefício da utilização de anti-hipertensores na prevenção de
compromisso cognitivo de origem vascular, contudo há outros estudos que refutam tal
proposição, especialmente em idosos (>80anos), havendo assim, ainda grande incerteza no
tratamento ideal do compromisso cognitivo de origem vascular associado à hipertensão
Arterial.
O objetivo desta tese foi fazer um levantamento sobre o conhecimento entre a relação HTACCV e sugerir processos de investigações laboratoriais e/ou clínicas.
Arterial hypertension affects more than two thirds of the worldwide population over 60 years of age, and 16,5% of the overall worldwide population, having heavy health related consequences, specially on vascular cognitive impairment (VCI). The pathological complex processes that lead to cerebral dysfunction are not yet completly understood and studied. It is known that hypertension has synergic and pathological association with the aging process on the development of VCI, by diminishing the homestatic cerebral environment and endothelial resilience to oxidative stress. Hypertension affects the cerebral structure and cerebrovascular function, by microvascular rarefaction, endothelial and functional hypermia dysfunction and small-vessel disease. Precocious diagnostic of VCI can be done by imagiological research of small-vessel disease, reflecting white matter hyperintensities, lacunar infarcts and microhaemorrhages. Various studies demonstrated the benefit of antihypertensive treatment for VCI prevention, however other studies suggest the contrary, specially on the elderly population (>80 years). Therefore, the ideal treatment of VCI due to hypertension has not yet been found. The main objective of this thesis was to survey what is known about the HTA-VCI relationship and suggest a laboratory/clinical investigation process.
Arterial hypertension affects more than two thirds of the worldwide population over 60 years of age, and 16,5% of the overall worldwide population, having heavy health related consequences, specially on vascular cognitive impairment (VCI). The pathological complex processes that lead to cerebral dysfunction are not yet completly understood and studied. It is known that hypertension has synergic and pathological association with the aging process on the development of VCI, by diminishing the homestatic cerebral environment and endothelial resilience to oxidative stress. Hypertension affects the cerebral structure and cerebrovascular function, by microvascular rarefaction, endothelial and functional hypermia dysfunction and small-vessel disease. Precocious diagnostic of VCI can be done by imagiological research of small-vessel disease, reflecting white matter hyperintensities, lacunar infarcts and microhaemorrhages. Various studies demonstrated the benefit of antihypertensive treatment for VCI prevention, however other studies suggest the contrary, specially on the elderly population (>80 years). Therefore, the ideal treatment of VCI due to hypertension has not yet been found. The main objective of this thesis was to survey what is known about the HTA-VCI relationship and suggest a laboratory/clinical investigation process.
Description
Keywords
Compromisso Cognitivo de Origem Vascular Demência Vascular Função Cognitiva Hipertensão Arterial Terapia Anti-Hipertensiva