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High blood pressure (BP) and hypertension are critical to manage because of their profound impact on brain health. Chronic hypertension accelerates cerebrovascular damage and contributes significantly to the development of both microvascular and macrovascular pathologies. Persistent elevated BP can lead to endothelial dysfunction, increased arterial stiffness, and atherosclerosis, which collectively exacerbate the risk of cerebrovascular events such as stroke. Moreover, hypertension is closely linked to cognitive decline and the development of neurodegenerative diseases, including vascular dementia and Alzheimer's disease. Effective BP management is essential to mitigate these risks, preserve cerebrovascular integrity, and maintain cognitive function. Clinicians and researchers must prioritize early detection and personalized intervention strategies to control hypertension, ultimately promoting long-term brain health and reducing the burden of cerebrovascular and neurodegenerative diseases.
Webinars : https://www.healthquality.va.gov/guidelines/CD/htn/TRAINAnnouncementEnduringHypertension2020.pdf
VA/DoD Clinical Practice Guidelines
https://www.healthquality.va.gov/guidelines/CD/htn/VADODHypertensionCPG508Corrected792020.pdf
Depression affects brain health, with profound implications for both structural and functional integrity. Chronic depression is associated with alterations in the brain's neurochemistry and increased neuroinflammation. These changes can lead to structural abnormalities in key neurological regions, thereby impairing cognitive functions such as memory, executive function, and processing speed. Additionally, depression has been linked with an elevated risk for neurodegenerative diseases like Alzheimer's, as well as increased susceptibility to cerebrovascular events. Effective management of depression is crucial for preserving brain health, often involving a multifaceted approach that often includes treatments such as pharmacological treatment, evidence-informed psychotherapy, and lifestyle modifications. For clinicians and researchers, understanding the intricate relationship between depression and brain health is essential to develop targeted interventions that not only alleviate depressive symptoms but also enhance overall cognitive function and resilience against neurological disorders.
Webinars: https://www.healthquality.va.gov/guidelines/MH/mdd/TRAINEnduringMajorDepressiveDisorderCPG2022.pdf
VA/DoD Clinical Practice Guidelines:
https://www.healthquality.va.gov/guidelines/mh/mdd/index.asp
https://www.healthquality.va.gov/guidelines/MH/mdd/VADODMDDCPGFinal508.pdf
Effective management of insomnia is paramount for maintaining brain health due to its significant impact on cognitive and neurological functions. Chronic insomnia can disrupt memory consolidation, impair executive function, and hinder emotional regulation, leading to both acute and long-term cognitive deficits. Persistent sleep deprivation associated with insomnia affects neuroplasticity, increasing the risk of neurodegenerative diseases. Additionally, insomnia is linked to heightened neuroinflammation, which can exacerbate existing cognitive conditions and contribute to declines in mental health.
Insomnia also adversely affects the glymphatic system, a crucial mechanism responsible for clearing metabolic waste and toxins from the brain during sleep. Impairment of this system can lead to the accumulation of neurotoxic substances, further increasing the risk of neurodegenerative diseases. Proper functioning of the glymphatic system is essential for brain health, and chronic sleep disturbances undermine this critical process.
For clinicians and researchers, early identification and targeted treatment of insomnia are crucial. Evidence-based approaches such as cognitive-behavioral therapy for insomnia (CBT-I), pharmacological interventions, and lifestyle modifications are essential for improving sleep quality and duration. By prioritizing these interventions, clinicians can enhance cognitive function, support neuroprotective mechanisms, ensure the effective functioning of the glymphatic system, and reduce the risk of long-term neurological and psychiatric disorders.
There are other sleep-related conditions to consider for brain health (e.g., sleep apnea) – we have focused on insomnia here, but these should also be considered in the course of patient care.
Webinars: Coming Soon
VA/DoD Clinical Practice Guidelines:
https://www.healthquality.va.gov/guidelines/CD/insomnia/index.asp
https://www.healthquality.va.gov/guidelines/CD/insomnia/I-OSA-CPG_2025-Guildeline_final_20250205.pdf
Common Data Elements:
Many efforts have been implemented to track and unify data elements across sites and studies. For more information on these efforts, please follow the below links:
NINDS Common Data Elements: Welcome | NINDS CDE
Precise-TBI Common Data Elements: Common Data Elements | PRECISE-TBI
TBI Impact Common Data Elements: Common Data Elements | TBI-IMPACT.org