High Blood Pressure May Prompt Mental Decline

Prehypertension and hypertension in midlife may raise the risk of later cognitive decline

(RxWiki News) High blood pressure affects 1 in 3 US adults and is tied to an increased risk of stroke, heart attack and other serious conditions, reports the National Heart, Lung, and Blood Institute (NHLBI). But high blood pressure in midlife may also forecast mental decline later.

Citing past studies that suggested a link between high blood pressure and reduced mental performance, researchers set out to study this possible link.

They found that patients with high blood pressure in midlife had a higher risk of later losing brain function than patients with normal blood pressure.

"Poor vascular health has been associated with an increased risk of dementia.  Patients with cardiovascular disease have even been shown to have changes in brain cortical thickness. Blood pressure along with diabetes, weight, family history and high cholesterol are some of the principle markers we use today to monitor vascular health," said Sadat Shamim, MD, Director of Inpatient Neurology and Neurophysiology at the Baylor University Medical Center in Dallas.

"The midlife blood pressure correlation described in this study is interesting in light of some previous studies that actually suggested that tight control of blood pressure and blood sugar in the elderly population to be potentially detrimental," said Dr. Shamim, who was not involved in this study.

"This may suggest that there is benefit in controlling many of these risk factors earlier and that in later stages the vascular disease may have set in to the point that the benefits are less," he said.

For this research, Rebecca F. Gottesman, MD, PhD, and colleagues recruited 13,476 patients.

Blood pressure is the measurement of force in arteries and vessels as blood pumps through the body. Hypertension, or high blood pressure, is a common condition that can be related to lifestyle. It can often be controlled with diet and exercise.

Hypertension risk factors include being obese, being stressed, drinking too much and smoking. Treatments include medication, exercise and diet changes.

Study patients were between 45 and 64 years old. They lived in Maryland, North Carolina, Mississippi and Minnesota. During the 20-year study period, the researchers examined the patients five times and interviewed them by phone each year.

The researchers measured the patients' blood pressure. They also gave them brain function exams to test memory and other measures of cognition.

Patients who had hypertension at the beginning of the study had more of a decline in brain function than those with normal blood pressure.

The authors found that patients with hypertension at the start of the study were two times more likely to die before the study was finished than those with normal blood pressure.

Dr. Gottesman, of the Johns Hopkins University School of Medicine in Baltimore, MD, and team also looked at the risks tied to prehypertension.

Prehypertension, marked by somewhat raised blood pressure, can forecast the development of hypertension.

The study was published online Oct. 13 in JAMA Neurology.

The NHLBI, the National Institute on Aging and the National Institute of Neurological Disorders and Stroke funded the research. One study author disclosed serving as an editor of the publishing journal and as a consultant for pharmaceutical companies.

Review Date: 
October 13, 2014