Blood Pressure a Harbinger of Brain Problems

Small vessel brain disease and cognitive decline linked to high ambulatory blood pressure

(RxWiki News) More recently doctors have told patients that ambulatory blood pressure monitoring may be a more accurate predictor of high blood pressure. It also may be the best predictor of cognitive decline and small vessel brain disease among older individuals.

Ambulatory blood pressure is measured through a small recording device that periodically takes blood pressure readings while patients perform their normal routines at work and home.

"Ask your doctor if ambulatory blood pressure monitoring would be helpful."

Dr. William B. White, senior author of the study and professor of hypertension and clinical pharmacology in the Calhoun Cardiology Center at the University of Connecticut School of Medicine, said that the study demonstrated for the first time in an older population that high blood pressure measured over a 24-hour period was associated with the progression of vascular brain disease, while a single measurement at a doctor's office indicating hypertension was not.

During the two-year study 72 patients with an average age of 82 underwent ambulatory blood pressure monitoring.  Three of the patients had severe medical problems. Researchers examined the change in blood pressure and the volume of white matter hyperintensities in the brain at the beginning of the study and after two years.

White matter hyperintensities suggest small vessel brain damage. They are detected through MRI imaging.

Investigators also measured cognitive ability and physical mobility over the study period as previous studies had suggested that white matter hyperintensities were linked to cognitive decline.

They found that worsening ambulatory blood pressure was associated with an increase in white matter hyperintensities and a decline in cognition and mobility. The average volume of white matter hyperintensities after adjustments for age and cholesterol also was found to increase significantly over the study period from 13.9 milliliters to 20.5 milliliters.

All of the cognitive measures and three out of four of the mobility measures were significantly related to white matter hyperintensities. No relationship was found between clinical blood pressure measurements and white matter hyperintensities.

Researchers suggested that targeting ambulatory blood pressure monitoring could help reduce the progression of small vessel brain disease and help older patients maintain mobility.

The clinical study was recently published in Circulation: Journal of the American Heart Association.

Review Date: 
November 22, 2011