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Dementia Risk Starts Early with High Blood Pressure

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You’ve just turned 50—the prime of your life. Your children are growing up, your career is established, and you may even be able to slip in a bit of recreation and relaxation. But how’s your blood pressure?

You may have assumed that you haven’t yet hit the age when you need to be that concerned about your blood pressure…much less your future risk for dementia. But that may not be true, according to the recent research published in European Heart Journal.

Background: Previous studies have established that high blood pressure during “midlife” increases risk for dementia in later life. However, in the earlier research, “midlife” had not been clearly defined—it could be, for example, anytime from one’s mid-30s to 60s. So researchers wondered: Is there a particular time when elevated blood pressure begins to have a meaningful impact on one’s odds of developing dementia years or even decades later? A recent UK study sheds new light on the question.

Study details: Over a 33-year study period, 385 of more than 8,600 participants developed dementia (at an average age of 75). When the researchers parsed the data, they determined that a systolic blood pressure (top number) reading of 130 mmHg or higher at age 50 was associated with a 45% higher risk for dementia later in life compared with a lower systolic reading. Interestingly, risk was not increased when study participants had that same blood pressure at age 60 or 70, nor was there any link between diastolic blood pressure (bottom number) readings and dementia risk.

“Our analysis suggests that the importance of midlife hypertension on brain health is due to the duration of exposure,” explained lead researcher Dr. Archana Singh-Manoux, a research professor at the French National Institute of Health and Medical Research. The researchers theorize that the increased dementia risk may be due to associations between high blood pressure and such factors as “silent” or mini-strokes and damage to white matter in the brain.

Another important detail: Even though a systolic reading of 130 mmHg is higher than normal, this is below the threshold when treatment for high blood pressure has traditionally begun. According to the revised American College of Cardiology and American Heart Association guidelines, stage 1 hypertension is now defined as a systolic reading of 130 to 139 mmHg or a diastolic reading of 80 to 89 mmHg. Those guidelines were changed to account for the medical complications—such as this increased dementia risk—that can occur at lower blood pressure levels. Current guidelines recommend treating stage 1 hypertension with lifestyle changes, such as physical activity and diet.

Takeaway: To keep your brain healthy, don’t wait until your 60s or beyond to keep a close eye on your blood pressure!

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Source: Study “Association Between Systolic Blood Pressure and Dementia in the Whitehall II Cohort Study: Role of Age, Duration, and Threshold Used to Define Hypertension” by researchers at the French National Institute of Health and Medical Research in Paris and University College London, published in European Heart Journal. Date: October 25, 2018 Publication: Bottom Line Health
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