High blood pressure (or rising blood pressure) in early middle age may increase dementia risk

The results of a study highlight the importance of managing blood pressure in early middle age to reduce the risk of damage to the brain (possibly dementia and Alzheimer’s) in later decades. The study findings suggest that people should have their blood pressure measured (and elevated blood pressure managed) starting around 40 years of age. Additionally, if a person’s blood pressure is rising between ages 43 and 53, that also increases risk and calls for blood pressure management.

“Findings suggest that routine and serial blood pressure measurement might need to start earlier than is typically considered (eg, around 40 years of age), and decisions to start treatment might need to be based not only on absolute blood pressure, but also longitudinal blood pressure change.”

The study, published in Lancet Neurology, found that study participants who had elevated blood pressure at age 53, or whose blood pressure was rising between age 43 and 53, had reduced brain volume at ages 69 to 71. The study participants also had lesions (tissue damage) in the white matter of their brains.* Although none of the participants had dementia at age 69-71, reduced brain volume and white matter lesions are associated with risk for dementia.**

It's estimated that around 30% of cases of dementia are potentially modifiable now, and while we're hunting for new treatment for the remaining 70%, we need to be able to optimize as much as we can to prevent dementia in the 30% where there's a modifiable cause," Schott said in an interview with MedPage Today.

*Brain white matter is made up of nerve fibers (axons) which connect the nerve cells (neurons). The axons are covered by a type of fatty sheath called myelin, which gives the tissue its white color. The myelin acts to insulate and protect the nerve fibers, and also improves the transmission of nerve impulses between the neurons.

** Lesions (damage to white matter in the brain is also called “White matter hyperintensities,” and these lesions “predict an increased risk of stroke, dementia, and death.”