Abstract
Hypertension, a major risk factor for cardiovascular diseases, has also been linked to cognitive decline and Alzheimer's disease (AD). This systematic review synthesizes the current evidence on how managing hypertension may influence cognitive health, particularly among elderly populations and those with cognitive impairments. By analyzing data from randomized controlled trials (RCTs), clinical trials, and cross-sectional studies, we evaluated the efficacy of various interventions, including pharmacological treatments, lifestyle modifications, and multidomain approaches that address blood pressure (BP) variability and intensive versus standard blood pressure control. Our findings reveal that effective blood pressure management can mitigate cognitive decline and potentially alter the course of Alzheimer's disease. However, the results also highlight complexities, such as the risk of adverse effects from intensive blood pressure control on cognitive processing and hippocampal volume. This review underscores the need for tailored hypertension management strategies that balance cardiovascular health with cognitive outcomes, suggesting that stabilizing blood pressure variability could play a crucial role. Future research should focus on longitudinal studies to refine these management strategies and enhance treatment guidelines, improving overall outcomes for patients at risk of cognitive decline.