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REVIEW ARTICLE

A review of hypertension and vascular cognitive impairment

Zhu Zhu1 ,  Siyu Duan2 ,  Xiandong Sun1*
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1 Department of Cardiology, Chifeng Clinical Medical College, Inner Mongolia Medical University, Chifeng, Inner Mongolia, China
2 Department of Neurology, Chifeng Municipal Hospital, Chifeng, Inner Mongolia, China
Brain & Heart, 025310044 https://doi.org/10.36922/BH025310044
Received: 1 August 2025 | Revised: 23 September 2025 | Accepted: 24 September 2025 | Published online: 10 October 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Vascular cognitive impairment (VCI) is a cognitive dysfunction syndrome caused by various vascular-related risk factors, with hypertension regarded as one of the main pathogenic factors. Chronic hypertension can promote cognitive decline through abnormal microcirculation structure, white matter fiber injury, blood–brain barrier destruction, oxidative stress, and neuroinflammatory reaction, increasing the incidence of vascular dementia. To fully grasp the research status in this field, this study adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines for literature identification. A controlled vocabulary-based search strategy was employed to screen PubMed, Embase, Web of Science, and Cochrane Library for human studies published from January 2000 to March 2025, focusing on hypertension, VCI, dementia, antihypertensive treatment, and aerobic exercise intervention. Analysis of literature shows that angiotensin converting enzyme inhibitors and calcium channel blockers may play a neuroprotective role by increasing cerebral blood flow, reducing oxidative stress, and delaying amyloid deposition. However, these mechanisms and their clinical results are still controversial. Aerobic exercise, particularly moderate and high-intensity exercise, can continuously improve cerebral blood flow, promote neuroplasticity development, and enhance cognitive performance. However, significant limitations remain in the existing research. Thus, it is essential to conduct a systematic, integrated analysis and further strengthen standardized experimental design and personalization.

Keywords
Hypertension
Cognitive impairment
Antihypertensive therapy
Aerobic exercise
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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Brain & Heart, Electronic ISSN: 2972-4139 Published by AccScience Publishing
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