Risk of Dementia & Hypertension

Middle-aged adults need to pay particular attention to their blood pressure according to a statement from the American Heart Association warning that the risk of developing dementia and cognitive impairment increases for individuals with high blood pressure.  In the United States around 75 million adults – or 1 in 3 adults – have high blood pressure also known as hypertension.

Worldwide, around 46.8 million people live with dementia.  It is estimated by 2050 dementia will affect around 131.5 million people globally.

The AHA statement was published in the journal Hypertension from research which analyzed strong evidence linking midlife hypertension to later-life cognitive decline.  The research team surmised that high blood pressure caused damage to white matter in the brain interfering with the structure and function of blood vessels located within the brain.  White matter is necessary for cognitive functioning and when it is damaged, it could possibly increase the risk of dementia.

One area looked at was whether the effects of antihypertensive medications reduced negative effects on cognitive function but researchers were unable to find evidence of any benefit.  The study was an observational study which is not designed to prove cause and effect.  A more effective study design that can prove cause and effect are randomized controlled studies.  This type of study would be better for proving if medication to treat high blood pressure during middle age did indeed help reduce the development of dementia later in life.

A study called the SPRINT-MIND study – a trial funded by the National Institutes of Health – is designed to determine how treating hypertension affects cognitive function which in the future may provide answers to determine the best way to treat hypertension with the goal to reduce dementia. 

At this time, the researchers recommend for physicians to continue to treat hypertensive patients on an individualized basis in order to protect their brain from developing dementia in addition to protecting their kidneys and heart. 

Other ways individuals can lower their blood pressure include:

·        Lose weight if overweight – even just 10 pounds can make a difference

·        Exercise regularly

·        Reduce sodium in your diet to no more than 2300 milligrams a day.  Just one teaspoon of salt contains 2300 milligrams.  Use more herbs and spices to season food.

·        Limit the amount of alcohol

·        Quit smoking

·        Reduce stress

·        Monitor blood pressure at home