High blood pressure treatment may slow cognitive decline
September 5, 2019
Science Daily/American Heart Association
Among middle-aged and older adults, high blood pressure accelerated cognitive decline and treatment slowed the regression. The rate of cognitive decline was similar between adults receiving high blood pressure treatment and those who did not have high blood pressure at all.
High blood pressure appears to accelerate cognitive decline among middle-aged and older adults and treating high blood pressure may slow down the process, according to a preliminary research presented at the American Heart Association's Hypertension 2019 Scientific Sessions.
The findings are important because high blood pressure and cognitive decline are two of the most common conditions associated with aging, and more people are living longer worldwide.
According to the American Heart Association's 2017 Hypertension Guidelines, high blood pressure is a global health threat, affecting approximately 80 million U.S. adults and one billion people globally. Moreover, the relationship between brain health and high blood pressure is a growing interest as researchers examine how elevated blood pressure affects the brain's blood vessels, which in turn, may impact memory, language and thinking skills.
In this observational study, researchers from Columbia University analyzed data collected on nearly 11,000 adults from the China Health and Retirement Longitudinal Study (CHARLS) between 2011-2015, to assess how high blood pressure and its treatment may influence cognitive decline. High blood pressure was defined as having a systolic blood pressure of 140 mmHg or higher and a diastolic blood pressure of 90 mmHg or higher, and/or taking antihypertensive medications. (Note: The American Heart Association guidelines define high blood pressure as 130 mmHg or higher or a diastolic reading of 80 mmHg or higher.)
Researchers in China interviewed study participants at home about their high blood pressure treatment, education level and noted if they lived in a rural or urban environment. They were also asked to perform cognitive tests, such as immediately recalling words as part of a memory quiz.
Among the study's findings:
Overall cognition scores declined over the four-year study;
Participants ages 55 and older who had high blood pressure showed a more rapid rate of cognitive decline compared with participants who were being treated for high blood pressure and those who did not have high blood pressure; and
The rate of cognitive decline was similar between those receiving high blood pressure treatment and those who did not have high blood pressure.
The study did not evaluate why or how high blood pressure treatments may have contributed to slower cognitive decline or if some treatments were more effective than others.
"We think efforts should be made to expand high blood pressure screenings, especially for at-risk populations, because so many people are not aware that they have high blood pressure that should be treated," said presenting study author Shumin Rui, a biostatistician at the Mailman School of Public Health, Columbia University in New York. "This study focused on middle-aged and older adults in China, however, we believe our results could apply to populations elsewhere as well. We need to better understand how high blood pressure treatments may protect against cognitive decline and look at how high blood pressure and cognitive decline are occurring together."
Greater blood pressure control linked to better brain health
August 13, 2019
Science Daily/University of Texas at Austin
For adults with high blood pressure, greater blood pressure control than what's currently considered standard is associated with fewer adverse changes of the brain, which could mean lower risks of dementia and cognitive impairment, according to new research published in the Journal of the American Medical Association.
Specifically, the magnetic resonance imaging (MRI) study of 449 adults showed that those with high blood pressure who achieved systolic blood pressure of less than 120 mm Hg -- known as "intensive" blood pressure control -- had a small but significantly lower amount of white matter lesions on their brain but a slightly greater decrease in brain volume than similar patients who achieved the current standard for healthy blood pressure of 140 mm Hg.
"The great news from this research is that high blood pressure is a treatable condition, and if you treat high blood pressure aggressively, you could have a positive benefit on cognition and brain structure," said R. Nick Bryan, M.D., Ph.D., chair and professor of the Department of Diagnostic Medicine at Dell Medical School at The University of Texas at Austin. "Though the benefit may be small, it's one of the few impactful cognition-related interventions we have."
White matter brain lesions are well-documented to be associated with a greater likelihood or intensity of cognitive decline. According to the American Heart Association, high blood pressure is considered 130 mm Hg or higher.
The current study supports the findings of a related study published in January that showed intensive blood pressure control is associated with fewer incidents of cognitive adverse events. Both studies were part of a larger body of NIH-funded research known as Systolic Blood Pressure Intervention Trial (SPRINT), designed to determine the protective value of lower blood pressure for heart, kidney and brain health. Previous research within SPRINT also showed that intensive blood pressure control among people with hypertension is linked to better outcomes in terms of risks of heart attack, heart failure and death.
In the current study, researchers compared MRI scans of adults age 50 and older, average age 67 years old, with systolic blood pressure between 130 and 180 mm Hg at baseline and four years later, noting white matter lesions and brain volume.
The next step in this investigation is to understand the effects of intensive blood pressure control among younger adults, such as those in their 40s, said Bryan. "We need to understand how aggressive should we be with blood pressure control when we're earlier on in the process," he said.
https://www.sciencedaily.com/releases/2019/08/190813130435.htm