Cardiovascular disease, the leading cause of morbidity and mortality in the United States and many other countries, confers substantial risk for cerebrovascular events, such as stroke and vascular dementia. The neuropsychological sequelae of such conditions are well documented and can have a devastating impact on individuals' quality of life. However, prior to the development of overt cerebrovascular complications, persons with cardiovascular disease or its risk factors may display mild to severe neuropsychological difficulties. Medical and surgical treatments for cardiovascular disease have also been found to affect neuropsychological function. This landmark volume offers the first comprehensive overview of the neuropsychological consequences of cardiovascular disease, tracking its natural history, epidemiology, and treatments. It encourages researchers and clinicians to consider all relevant facets of vascular disease processes in their evaluation, study, and treatment of affected patients and indicates a need for primary and secondary prevention efforts. Neuropsychology of Cardiovascular Disease will be welcomed as an invaluable resource by neuropsychologists, specialists in behavioral medicine, neurologists, cardiologists, epidemiologists, gerontologists, and many other health professionals whose work brings them into contact with these challenging patients.

Cardiovascular disease (CVD), in broad terms, comprises diseases of the heart, blood vessels, and circulation. The most common CVDs are hypertension, coronary artery disease (CAD), cerebrovascular disease, and peripheral vascular disease (aneurysms and peripheral arterial disease [PAD]; see Table 1.1). Other CVDs include congenital heart disease, rheumatic heart disease, valvular heart disease, congestive heart failure, and cardiac arrhythmias. Some researchers use the term coronary heart disease (CHD) interchangeably with CAD. However, CAD more specifically refers to atheroscerotic disease of the coronary arteries, whereas CHD can be caused by atherosderotic and nonatherosclerotic (e.g., autoimmune, infectious) processes. This chapter provides an overview of the prevalence and clinical manifestations of hypertension and the atherosclerotic diseases examined in subsequent chapters of this book.

Prevalence of Cardiovascular Disease

It is estimated that approximately 50 million adults in the United States have hypertension (Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, 1997), 12 million . . .