Post by alice on Sept 23, 2014 15:41:14 GMT -5
High Blood Pressure in Midlife Raises Dementia Risk
People with high blood pressure in middle age are more likely to suffer from thinking and memory problems in old age, raising their risk of dementia. Those are the findings of a large new study that looked at men and women over a 20-year period.
The findings are important because more than two thirds of Americans over 60 have high blood pressure, as do many younger adults. Keeping blood pressure controlled through medications and other measures, the study showed, can help to preserve memory and thinking skills into old age. Blood pressure control is also critical for preventing strokes and heart attacks.
Earlier studies have suggested that high blood pressure during middle age may make people particularly susceptible to cognitive problems and dementia down the road. Recent estimates suggest, for example, that 8 percent of Alzheimer’s cases may be attributed to midlife hypertension, according to an editorial that accompanied the latest report.
The study, known as the Atherosclerosis Risk in Communities (ARIC) study, is larger and longer lasting than previous studies. Researchers looked at 13,476 men and women who ranged in age from 48 to 67. They came from diverse communities in Minnesota, Maryland, North Carolina and Mississippi, and participants were followed for up to 23 years.
The study began in 1987, and participants were given three comprehensive tests of thinking and memory skills at regular periods, from 1990 to 1992, from 1996 to 1998, and from 2011 to 2013. They also got regular follow-up calls and came in for additional check-ups.
At the end of the study period, the researchers found that those individuals who had high blood pressure in middle age had worse memory and thinking abilities than those with normal blood pressure in midlife. Normal blood pressure was defined as 120/80 in those who were not on medications. High blood pressure was defined as an upper blood pressure number of 140 or above, or a lower number of 90 or above.
Those with borderline high blood pressure (an upper number of 120 to 139, or a lower number of 80 to 89) also scored worse on memory tests, though not as poorly as those with high blood pressure. The findings were published in the Journal of the American Medical Association's publication, Neurology.
For those with hypertension, keeping blood pressure under control seemed to ease the risk of having cognitive decline. In addition to medications, weight loss, exercise and restricting your salt intake can all help to keep blood pressure in check.
In the study, those who developed high blood pressure late in life did not show higher rates of cognitive decline. Blood pressure seemed to exert its most damaging effects earlier in life, during middle age. Thus, it appears to be particularly important to manage blood pressure in midlife, before it can take a lasting toll on the brain.
By ALZinfo.org, The Alzheimer's Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer's Research Foundation at The Rockefeller University.
Source: Rebecca F. Gottesman MD, PhD, Andrea L. C. Schneider MD, PhD, Marilyn Albert PhD, et al: “Midlife Hypertension and 20-Year Cognitive Change. The Atherosclerosis Risk in Communities Neurocognitive Study.” JAMA Neurology, August 4, 2014
Philip B. Gorelick MD, MPH: “Blood Pressure and the Prevention of Cognitive Impairment” (editorial). JAMA Neurology, Vol. 71 (10), August 4, 2014