Beyond subjective cognitive failures in patients with hypertension?

Subjective cognitive failures (SCF) are frequent in the elderly and have traditionally been considered as a manifestation of natural or physiological aging. Sufferers describe them to family and friends as forgetting to do things they had proposed, temporal and spatial absentmindedness when out and about, or difficulties in remembering the names of acquaintances or familiar buildings or landmarks. SCF are usually regarded as something normal in the elderly but start to be considered as a warning sign of possible cognitive impairment and the first sign of dementia when they become frequent and affect the family environment. In these circumstances, SCF are usually first reported to the family physician, who may or may not initiate examinations to objectively determine the magnitude of the possible cognitive impairment, the repercussions on daily life, and the effect on the future of the elderly person. With the progressive aging of the population in the most developed countries, because of greater access to health care and the success of preventive and curative medicine, this type of behavioral deterioration has become more frequent and more evident in the elderly. In addition, various studies have demonstrated an association between SCF and cardiovascular risk factors and clinical cardiovascular disease in the context of generalized arteriosclerosis. Likewise, SCF has been linked not only with cerebral vascular disease but also with coronary artery disease, peripheral artery disease, and renal failure. Given that hypertension is the most important cardiovascular risk factor, there is growing interest in the relationship between hypertension and cognitive impairment, as shown by the increasing number of reports on this subject. In the past 5 years, more articles have been published on this relationship than in the preceding 50 years. The border between what may be considered as physiological and pathological cognitive impairment is diffuse and has never been precisely identified. The right time for objective examination of cognitive function in a patient having SCF in daily life is unclear. However, this is of great importance because if cognitive impairment is an expression of functional