Hypertension impairs neurovascular coupling and promotes microvascular injury: role in exacerbation of Alzheimer’s disease
Open accessAbstract
Hypertension in the elderly substantially increases both the risk of vascular cognitive impairment (VCI) and Alzheimer's disease (AD); however, the underlying mechanisms are not completely understood. This review discusses the effects of hypertension on structural and functional integrity of cerebral microcirculation, including hypertension-induced alterations in neurovascular coupling responses, cellular and molecular mechanisms involved in microvascular damage (capillary rarefaction, blood-brain barrier disruption), and the genesis of cerebral microhemorrhages and their potential role in exacerbation of cognitive decline associated with AD. Understanding and targeting the hypertension-induced cerebromicrovascular alterations that are involved in the onset and progression of AD and contribute to cognitive impairment are expected to have a major role in preserving brain health in high-risk older individuals.
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Aging-induced dysregulation of microvascular endothelial function and phenotype critically contributes to the pathogenesis of both vascular cognitive impairment (VCI) and Alzheimer's disease (AD).
“There is strong evidence that aging-induced dysregulation of microvascular endothelial function and phenotype critically contributes to the pathogenesis of both vascular cognitive impairment (VCI) and Alzheimer ' s disease (AD)”
From Single-cell RNA sequencing identifies senescent cerebromicrovascular endothelial cells in the aged mouse brain (2020) · cites this paper as Csiszar et al. 2017
The Introduction (page not available) states that old age promotes microvascular endothelial dysfunction and is associated with dysregulated endothelial angiogenesis. It links these changes to microvascular injury in older patients with AD, but frames that link as likely and does not establish that aging-induced endothelial changes critically cause both VCI and AD. The paper’s emphasis is on hypertension and its interaction with aging and AD. (LLM, conf=0.83)
Experimental — accuracy not yet measuredAging decreases capillary density (microvascular rarefaction) in the brain.
“Aging decreases capillary density (known as ' microvascular rarefaction ' ) (Csiszar et al. 2017; Tarantini et al. 2016; Tucsek et al. 2014a; Ungvari et al. 2013a; Banki et al. 2015; Toth et al. 2017)”
From Single-cell RNA sequencing identifies senescent cerebromicrovascular endothelial cells in the aged mouse brain (2020) · cites this paper as Csiszar et al. 2017
The Introduction defines cerebromicrovascular rarefaction as a decline in brain capillarization and says that old age significantly exacerbates hypertension-induced rarefaction. It does not state that aging alone decreases brain capillary density, so the claim omits an important condition. (LLM, conf=0.86)
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Dr. Doody and colleagues reply
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Alzheimer’s Disease and Vascular Aging
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The Systemic Effects of Exercise on the Systemic Effects of Alzheimer’s Disease
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- Authors
- Csiszar, A., Tarantini, S., Fülöp, G. A., Kiss, T., Valcarcel-Ares, M. N., Galvan, V., Ungvari, Z., & Yabluchanskiy, A.
- Affiliations
- University of Oklahoma Health Sciences Center (US)
- University of Debrecen (HU)
- Corresponding author
- Yabluchanskiy, Andriy
- Venue
- GeroScience
- Published
- 2017-08
- Volume
- 39
- Issue
- 4
- Pages
- 359-372
- ISSN
- 2152-4041 (ISSN-L)
- 2509-2715
- 2509-2723
- PMC
- PMC5636770
- OpenAlex
- W2752221960
- Cited by
- 93
- References
- 194
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 5 · 2023: 9 · 2022: 11 · 2021: 7 · 2020: 20 · 2019: 20 · 2018: 8 · 2017: 1
- FWCI
- 6.67
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- GeroScience (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- University of Debrecen Electronic Archive (University of Debrecen) (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs (I01 BX002211, I01 BX002595)
- American Heart Association
- Oklahoma Center for the Advancement of Science and Technology
- National Institutes of Health (1r01ag047879-01, 5r01ag038747-05)
- National Institute on Aging (R01‐AG038747, R01‐AG047879, P30AG013319, P30AG050911, R01AG055395, T32AG052363)
- National Institute of General Medical Sciences (U54GM104938)
- National Institute of Neurological Disorders and Stroke (R01NS056218)
- National Center for Complementary and Integrative Health (R01AT006526)
- Topics
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Life Sciences › Neuroscience › Neurology › Barrier Structure and Function Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- hypertension, Alzheimer's disease, neurovascular coupling, cerebral microcirculation, microvascular damage, capillary rarefaction, blood-brain barrier disruption, cerebral microhemorrhages, vascular cognitive impairment, cognitive decline
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