Higher blood pressure as a risk factor for diseases other than stroke and ischemic heart disease.

Hypertension is an established risk factor for stroke, ischemic heart disease,1,2 and renal dysfunction.3 The management and prevention of hypertension are important to the prevention of these diseases. Recent evidence has suggested that hypertension also plays a central role in the underlying pathophysiological condition or at prodromal stages before the development of these diseases. Accumulating evidence also indicates that hypertension seems to be linked with common noncardiovascular diseases including dementia, cancer, oral health diseases (OHDs), and osteoporosis. In this brief review, we organize the reported results about the associations between hypertension and these diseases, discussing mainly epidemiological surveys, with the goal of clarifying the relationships between these diseases and hypertension. ### Atrial Fibrillation Atrial fibrillation (AF) is one of the most common types of chronic arrhythmia and is a risk factor for ischemic stroke.4 The Framingham Heart Study revealed that hypertension increases the risk of AF by factors of 1.5 for men and 1.4 for women.5 The Women’s Health Study and a cohort study of Norwegian men showed that high-normal blood pressure (BP) was associated with incident AF.6,7 All of these cohort studies were conducted in Westerners, and these associations were also confirmed in a recent Japanese cohort study.8 In that investigation, compared with normal BP and normal weight, systolic prehypertension with overweight was shown to be associated with an increased risk of incident AF ( P for interaction=0.04). Arterial stiffness, left ventricular hypertrophy, and increased left atrial size are important mediators of the relationship between BP and incident AF.9 Higher systolic BP (SBP) and overweight may mutually exacerbate left ventricular hypertrophy and hypertension, and consequently, they may synergistically increase the risk of AF. ### Chronic Kidney Disease and High BP Chronic kidney disease (CKD) is characterized by a progressive decline in an individual’s glomerular filtration rate over several decades, …

[1]  B. Lernfelt,et al.  15-year longitudinal study of blood pressure and dementia , 1996, The Lancet.

[2]  L. Hansson,et al.  Hypertension is related to cognitive impairment: a 20-year follow-up of 999 men. , 1998, Hypertension.

[3]  M. Drangsholt,et al.  Periodontal disease and coronary heart disease risk. , 2000, JAMA.

[4]  U. Goldbourt,et al.  Is there an association between hypertension and cancer mortality? , 2002, The American journal of medicine.

[5]  Carole Dufouil,et al.  Antihypertensive Treatment and Change in Blood Pressure Are Associated With the Progression of White Matter Lesion Volumes: The Three-City (3C)–Dijon Magnetic Resonance Imaging Study , 2011, Circulation.

[6]  Harry Hemingway,et al.  Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1·25 million people , 2014, The Lancet.

[7]  R. Berg,et al.  Prevalence of hypertension in 1,795 subjects with chronic renal disease: the modification of diet in renal disease study baseline cohort. Modification of Diet in Renal Disease Study Group. , 1996, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[8]  B Järvholm,et al.  Obesity, hypertension, and the risk of kidney cancer in men. , 2000, The New England journal of medicine.

[9]  Keith C. Norris,et al.  Vitamin D and the cardiovascular system. , 2009, Clinical journal of the American Society of Nephrology : CJASN.

[10]  N. Shock,et al.  Association between blood pressure and the rate of decline in renal function with age. , 1984, Kidney international.

[11]  A. Hingorani,et al.  Is periodontal inflammation associated with raised blood pressure? Evidence from a National US survey , 2010, Journal of hypertension.

[12]  M. Fujishima,et al.  Altered diurnal variation of blood pressure in elderly subjects with decreased activity of daily living and impaired cognitive function. , 2001, Hypertension research : official journal of the Japanese Society of Hypertension.

[13]  Alan S. Brown,et al.  ACCF/AHA 2011 expert consensus document on hypertension in the elderly: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. , 2011, Circulation.

[14]  Y. Kokubo,et al.  Additive interaction of oral health disorders on risk of hypertension in a Japanese urban population: the Suita Study. , 2014, American journal of hypertension.

[15]  Y. Kokubo,et al.  Relationship Between Blood Pressure Category and Incidence of Stroke and Myocardial Infarction in an Urban Japanese Population With and Without Chronic Kidney Disease: The Suita Study , 2009, Stroke.

[16]  Alan Bensoussan,et al.  Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis , 2007, The Lancet.

[17]  J. Svartberg,et al.  Serum parathyroid hormone as a predictor of increase in systolic blood pressure in men , 2005, Journal of hypertension.

[18]  S. Yusuf,et al.  Effects of aspirin plus extended-release dipyridamole versus clopidogrel and telmisartan on disability and cognitive function after recurrent stroke in patients with ischaemic stroke in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial: a double-blind, active and placebo , 2008, The Lancet Neurology.

[19]  Periodontal disease and hypertension: a chicken and egg story? , 2010, Journal of hypertension.

[20]  G. Pizzolato,et al.  Risk factors for vascular dementia: Hypotension as a key point , 2008, Vascular health and risk management.

[21]  Jackson T. Wright,et al.  2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). , 2014, JAMA.

[22]  W. Stead,et al.  Progression of renal insufficiency: role of blood pressure. , 1989, Kidney international.

[23]  A. Vissink,et al.  Increased prevalence of cardiovascular and autoimmune diseases in periodontitis patients: a cross-sectional study. , 2010, Journal of periodontology.

[24]  J. Imig Epoxyeicosatrienoic Acids , Hypertension , and Kidney Injury , 2022 .

[25]  L. Lind,et al.  Severity of periodontal disease and number of remaining teeth are related to the prevalence of myocardial infarction and hypertension in a study based on 4,254 subjects. , 2006, Journal of periodontology.

[26]  M. Visser,et al.  Vitamin D status and parathyroid hormone levels in relation to blood pressure: a population‐based study in older men and women , 2007, Journal of internal medicine.

[27]  Y. Ohashi,et al.  Impact of Kidney Disease and Blood Pressure on the Development of Cardiovascular Disease: An Overview From the Japan Arteriosclerosis Longitudinal Study , 2008, Circulation.

[28]  T. Pieber,et al.  Vitamin D status and arterial hypertension: a systematic review , 2009, Nature Reviews Cardiology.

[29]  Shen-Chih Chang,et al.  Low glomerular filtration rate and risk of stroke: meta-analysis , 2010, BMJ : British Medical Journal.

[30]  Y. Doi,et al.  Postural dysregulation in systolic blood pressure is associated with worsened scoring on neurobehavioral function tests and leukoaraiosis in the older elderly living in a community. , 1997, Stroke.

[31]  Willie Lawrence,et al.  An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention , 2013, Hypertension.

[32]  N. Lassen,et al.  Multi-infarct dementia. A cause of mental deterioration in the elderly. , 1974, Lancet.

[33]  Charles E. McCulloch,et al.  CHRONIC KIDNEY DISEASE AND THE RISKS OF DEATH, CARDIOVASCULAR EVENTS, AND HOSPITALIZATION , 2004 .

[34]  J. Geleijnse Vitamin D and the prevention of hypertension and cardiovascular diseases: a review of the current evidence. , 2011, American journal of hypertension.

[35]  Robert J. Glynn,et al.  Influence of Systolic and Diastolic Blood Pressure on the Risk of Incident Atrial Fibrillation in Women , 2009, Circulation.

[36]  I. Hajjar,et al.  The relationship between blood pressure and cognitive function , 2010, Nature Reviews Cardiology.

[37]  K. Tsuruya,et al.  Cardiorenal syndrome in chronic kidney disease , 2015, Current opinion in nephrology and hypertension.

[38]  S. Kashyap,et al.  Metabolic syndrome and kidney disease: a systematic review and meta-analysis. , 2011, Clinical journal of the American Society of Nephrology : CJASN.

[39]  M. Kivimäki,et al.  Modifiable cardiovascular disease risk factors as predictors of dementia death: pooling of ten general population-based cohort studies , 2014, Journal of Negative Results in BioMedicine.

[40]  D. Spiegelman,et al.  Periodontal disease and incidence of hypertension in the health professionals follow-up study. , 2012, American journal of hypertension.

[41]  C. Anderson,et al.  Severe Cerebral White Matter Hyperintensities Predict Severe Cognitive Decline in Patients With Cerebrovascular Disease History , 2009, Stroke.

[42]  R. Mayeux,et al.  The relationship of hypertension in the elderly to AD, vascular dementia, and cognitive function , 2002, Neurology.

[43]  O. Hanon,et al.  Antihypertensive Drugs, Prevention of Cognitive Decline and Dementia: A Systematic Review of Observational Studies, Randomized Controlled Trials and Meta-Analyses, with Discussion of Potential Mechanisms , 2015, CNS Drugs.

[44]  T. Ninomiya,et al.  Dietary patterns and risk of dementia in an elderly Japanese population: the Hisayama Study. , 2013, The American journal of clinical nutrition.

[45]  Yutaka Imai,et al.  The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2014) , 2014, Hypertension Research.

[46]  P. Stattin,et al.  Blood Pressure and Risk of Cancer Incidence and Mortality in the Metabolic Syndrome and Cancer Project , 2012, Hypertension.

[47]  L. Beckett,et al.  Current and remote blood pressure and cognitive decline. , 1999, JAMA.

[48]  J. Tuomilehto,et al.  Prevention of dementia in randomised double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial , 1998, The Lancet.

[49]  Neil Chapman,et al.  Effects of blood pressure lowering with perindopril and indapamide therapy on dementia and cognitive decline in patients with cerebrovascular disease. , 2003, Archives of internal medicine.

[50]  A. Hofman,et al.  Blood Pressure and Risk of Dementia: Results from the Rotterdam Study and the Gothenburg H-70 Study , 2000, Dementia and Geriatric Cognitive Disorders.

[51]  S. Gottlieb,et al.  Cardiorenal Syndrome: New Perspectives , 2010, Circulation.

[52]  G. Bray,et al.  A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. , 1997, The New England journal of medicine.

[53]  C. Tsioufis,et al.  Periodontitis and blood pressure: the concept of dental hypertension. , 2011, Atherosclerosis.

[54]  G. Davey Smith,et al.  Blood pressure and site-specific cancer mortality: evidence from the original Whitehall study , 2003, British Journal of Cancer.

[55]  K. Liestøl,et al.  Upper Normal Blood Pressures Predict Incident Atrial Fibrillation in Healthy Middle-Aged Men: A 35-Year Follow-Up Study , 2012, Hypertension.

[56]  D. Aarsland,et al.  Hypertension is a potential risk factor for vascular dementia: systematic review , 2011, International journal of geriatric psychiatry.

[57]  Michael Böhm,et al.  2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). , 2007, Journal of hypertension.

[58]  S. Black,et al.  Vascular Contributions to Cognitive Impairment and Dementia: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association , 2011, Stroke.

[59]  Rahul Wadke,et al.  Atrial fibrillation. , 2022, Disease-a-month : DM.

[60]  G. Remuzzi,et al.  Progression, remission, regression of chronic renal diseases , 2001, The Lancet.

[61]  A. Sheiham,et al.  Association of Edentulism and Diet and Nutrition in US Adults , 2003 .

[62]  J. Williamson,et al.  Angiotensin-converting enzyme inhibitors and cognitive decline in older adults with hypertension: results from the Cardiovascular Health Study. , 2009, Archives of internal medicine.

[63]  J. Marshall,et al.  Multi-infarct dementia , 1979, Journal of the Neurological Sciences.

[64]  P. Ponikowski,et al.  Cardiorenal syndromes: an executive summary from the consensus conference of the Acute Dialysis Quality Initiative (ADQI). , 2010, Contributions to nephrology.

[65]  R. Collins,et al.  Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies , 2002, The Lancet.

[66]  H. Arai,et al.  Angiotensin‐Converting Enzyme Inhibitors and Incidence of Alzheimer's Disease in Japan , 2004, Journal of the American Geriatrics Society.

[67]  G. Hallmans,et al.  Dental status, diet and cardiovascular risk factors in middle-aged people in northern Sweden. , 1994, Community dentistry and oral epidemiology.

[68]  S. Kanba,et al.  Midlife and Late-Life Blood Pressure and Dementia in Japanese Elderly: The Hisayama Study , 2011, Hypertension.

[69]  R. Sacco,et al.  Periodontal bacteria and hypertension: the oral infections and vascular disease epidemiology study (INVEST) , 2010, Journal of hypertension.

[70]  D. Levy,et al.  Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. , 1994, JAMA.

[71]  A. Taguchi,et al.  Tooth Loss Is Associated With an Increased Risk of Hypertension in Postmenopausal Women , 2004, Hypertension.

[72]  S. Yusuf,et al.  Renin-angiotensin system blockade and cognitive function in patients at high risk of cardiovascular disease: analysis of data from the ONTARGET and TRANSCEND studies , 2011, The Lancet Neurology.

[73]  Jianyu Zhang,et al.  Prehypertension and Incidence of ESRD: a systematic review and meta-analysis. , 2014, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[74]  J. O’Keefe,et al.  Vitamin D deficiency an important, common, and easily treatable cardiovascular risk factor? , 2008, Journal of the American College of Cardiology.

[75]  C. Bulpitt,et al.  Incident dementia and blood pressure lowering in the Hypertension in the Very Elderly Trial cognitive function assessment (HYVET-COG): a double-blind, placebo controlled trial , 2008, The Lancet Neurology.

[76]  A. Hofman,et al.  The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial , 2003, Journal of hypertension.

[77]  A. Anarat,et al.  Strict blood-pressure control and progression of renal failure in children. , 2009, The New England journal of medicine.

[78]  Jaakko Tuomilehto,et al.  The prevention of dementia with antihypertensive treatment: new evidence from the Systolic Hypertension in Europe (Syst-Eur) study. , 2002 .

[79]  U. John,et al.  Gender differences in the relation between number of teeth and systolic blood pressure , 2006, Journal of hypertension.

[80]  Lluís Mont,et al.  2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). , 2013, European heart journal.

[81]  J. Forman,et al.  Plasma 25-Hydroxyvitamin D and Regulation of the Renin-Angiotensin System in Humans , 2010, Hypertension.

[82]  R. Rubin,et al.  Enhanced Parathyroid Function in Essential Hypertension A Homeostatic Response to a Urinary Calcium Leak , 1980, Hypertension.