Controlling your blood pressure earlier may decrease your risk of dementia

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High blood pressure (hypertension) from mid-life to later life, as well as high mid-life blood pressure followed by low blood pressure (hypotension) later in life has been associated with an increased risk of dementia in a study from the US. Across six visits, the researchers recorded the blood pressure of nearly 5,000 patients from 1987 - 2013, as well as assessing dementia in the later visits. The findings showed that patients who experienced midlife hypertension and then late life hypotension were most at risk of developing dementia, while patients with sustained hypertension from mid to late life were also at an abnormal risk of dementia. This study can inform doctors of the patterns of blood pressure that are associated with increased dementia risk, so that mitigation measures can be prescribed.

Journal/conference: JAMA

DOI: 10.1001/jama.2019.10575

Organisation/s: John Hopkins University, Baltimore, USA

Funder: National Heart, Lung, and Blood Institute

Media Release

From: JAMA

Blood Pressure Patterns in Middle-Age, Older Adults Associated With Dementia Risk

Patterns of high blood pressure in midlife that extend to late life or high blood pressure in midlife followed by low blood pressure later in life was associated with increased risk for dementia compared to having normal blood pressure.

This observational study included nearly 4,800 participants who had blood pressure measurements taken over 24 years at five visits plus a detailed neurocognitive evaluation during the fifth and a sixth visit, where dementia was assessed.

There were 516 new cases of dementia diagnosed between the fifth and sixth visits. Study authors report that compared with maintaining normal blood pressure, an increased risk of dementia was associated with hypertension (greater than 140/90 mm Hg or use of antihypertensive medication) in midlife (age 54 to 63) that was sustained to late life and a pattern of hypertension in midlife and low blood pressure (less than 90/60 mm Hg) later life. Midlife hypertension followed by late-life low blood pressure also was associated with increased risk of mild cognitive impairment.

Limitations of the study include that the findings may have been biased because of the increased likelihood that participants with higher blood pressure and poorer cognition during midlife dropped out of the study.

Also, study participants were from Washington County, Maryland; Forsyth County, North Carolina; Jackson, Mississippi; and Minneapolis, so the results may not be generalizable to other areas.

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