Role of centrally active cardiovascular agents in cognitive disorders

•Any interruption of cerebral perfusion may result in cognitive disorders.•Evidence linking drugs to induction or prevention of cognitive disorders is mixed.•Use of cardiovascular drugs in certain patient subsets may cause cognitive changes.•Patients who are seriously ill, have cognition issues, or are elderly, are at most risk.

Cardiovascular drugs are used to treat patients with cardiac function and hemodynamic problems. Because of the relationship between the cardiovascular (CVS), and central nervous (CNS) systems, alteration of CVS activity can potentially alter CNS function. Of particular concern is regulation of lipids, because of the link between neural functionality, lipids, and cognitive disorders, and perfusion, because of the link between hypo-perfusion and vascular dementia. Positive and negative evidence of the effect of CVS drugs in cognitive disorders is available. Awareness of the need to tailor treatments with CVS drugs to patients with consideration of gender, race, lifestyle, and co-morbidities is increasing. Evidence for the importance of cerebral perfusion in vascular dementia development is strong, supporting the importance of physician vigilance in the treatment of hypertension, particularly in vulnerable populations. Evidence for the role of plasma lipid control in development of Alzheimer disease is not as strong. However, physician vigilance in treating hyperlipidemias is strongly encouraged, particularly in vulnerable populations.