Worried About Dementia? Control High Blood Pressure

People, middle-aged and older, often worry about declining memory and the possibility of facing Alzheimer’s disease in the future. While worry gets you nowhere, a new study presented at the Alzheimer’s Association International Conference in Chicago, offers hope that there are actionable steps individuals can take to stave off Mild Cognitive Impairment (MCI) and Alzheimer’s disease. To date, much of the research has focused on genetic risks and advancing age as triggers for Alzheimer’s. While these factors are beyond human control, the SPRINT study (Systolic Blood Pressure Intervention Trial) presents exciting news that people may be able to control their risk for dementia by controlling their high blood pressure. Consequently, the catchphrase, “what’s good for the heart is good for the brain” is grabbing more momentum as new evidence supports that lowering blood pressure reduces dementia risk.

The Study

The federally funded SPRINT study examined over 9,000 subjects ranging in age from 50 to 100. The average participant age was 68. All subjects were at risk of cardiovascular disease, none had diabetes, and none were diagnosed with dementia.

Study participants were randomly divided into two groups, creating a two-strategy comparison for controlling high blood pressure. The first group employed an intensive strategy. Participants were asked to lower their blood pressure to or below 120mmHg systolic. In contrast, the second group embraced a standard care strategy. This group targeted a systolic blood pressure goal of less than 140mmHg.

The Results

Study participants able to lower their blood pressure to the more intense 120mmHg saw their risk of developing Mild Cognitive Impairment – the gateway to dementia – drop by 19% compared to the other group. When looking at the combined outcome of MCI plus probable all-cause dementia, the risk was 15% lower in the intensive versus standard treatment group. “These encouraging results show, more conclusively than ever before, that there are things YOU CAN DO, especially when it comes to cardiovascular disease risk factors, to reduce your risk of MCI and dementia,” says Maria C. Carillo, PhD, Alzheimer’s Association Chief Science Operator.

High Blood Pressure and Your Brain

Alzheimer’s is suspected to begin decades before memory and thinking lapses occur. It is thought that high blood pressure in mid-life may be a contributory factor to this decline. There is no argument that the brain is quite vulnerable to the effects of high blood pressure. For instance, high blood pressure damages the brain’s blood vessels causing hardening of the arteries. It also affects the tiny blood vessels in the brain making it hard to control blood (and oxygen) flow which is crucial to keeping the brain functioning normally.

Although hypertension is considered a cardiovascular disease, high blood pressure affects multiple organ systems in the body including the brain. If left untreated, elevated blood pressure levels can lead to a major stroke, a series of small strokes, white and gray matter shrinkage, dead brain tissue and even late life cognitive decline that includes losses in overall thinking, memory and processing speed.

For years the connection between high blood pressure and impaired cognition and memory was assumed but not proven. Now, the SPRINT clinical trial has specifically addressed this link and has shown that the strict treatment of high blood pressure can reduce the risk of dementia and protect cognition.

This study’s major takeaway is that lifestyle change is critical if individuals want to control their risk for developing dementia. Medical or pharmacological interventions to slow or stop the progression of Alzheimer’s disease, MCI and other dementias have been elusive. This is what makes the SPRINT study so promising, that there are actionable steps individuals can take to lower their risk of cognitive decline.

What You Can Do to Protect Yourself

There are action steps  you can take to maintain a normal blood pressure to help keep your brain healthy.

  1. It is important to treat systolic blood pressure (the upper number) aggressively especially if you are 50 years or older. Work with your doctor and prescribed medicines to keep your systolic pressure at, around or below 120mmHG. Take your medications regularly and don’t miss doses.
  2. High blood pressure is a dangerous condition because for many people there are no symptoms. This is why individuals should regularly monitor their blood pressure. You can buy an automatic blood pressure monitoring device for a reasonable price. Another option, drugstore or neighborhood pharmacies, often offer blood pressure readings for free.
  3. Work with your physician to incorporate evidence-backed lifestyle changes into your daily routine. Remember what is good for the heart is good for the brain so diet and exercise play a huge role in blood pressure control.
  4. Cut out processed foods, even canned vegetables can be high in sodium. The best blood pressure-lowering diets to follow are the DASH (Dietary Approaches to Stop Hypertension) or a Mediterranean diet. Each of these diets are high in fresh fruits and vegetables, low-fat dairy items, fish and nuts. On the other hand, they reduce harmful fats, such as: red meat, sweets and sugary drinks.
  5. Lose weight. This is a challenging but attainable goal. A little weight loss can make a big difference.
  6. Don’t forget to exercise. It is not necessary to be an Olympic runner or weight lifter. Rather, incorporate regular and reasonable exercises into your daily routine. Take long walks, garden, swim, enjoy an aerobics or yoga class. The goal is to move.
More Research

Blood pressure control is important at all ages. However, strict control of blood pressure in mid-life is critical to prevent the onset of blood vessel damage and the slippery slope into dementia at later ages. A second study recently published in the journal, Neurology, found people living with higher blood pressure had, at death, more brain lesions, or areas of dead brain tissue that had lost its blood supply. The autopsies also showed evidence of tangles of tau protein, a hallmark of Alzheimer’s disease. This data combined with evidence from the SPRINT study supports the argument that keeping blood pressure under control can slow the deterioration of the brain which may lead to dementia and even Alzheimer’s disease in later life. Of course, the relationship between blood pressure and dementia requires further research. Yet, the general theme is clear – there is something people can do to help their brains function normally, maintain a healthy heart and reduce dementia risk – keep blood pressure under control.

What Blood Pressure Readings Mean

90 over 60 (90/60) or less: You may have low blood pressure.

More than 90 over 60 (90/60) and less than 120 over 80 (120/80): Your blood pressure reading is ideal and healthy.

More than 120 over 80 and less than 140 over 90 (120/80 – 140/90): You have a normal blood pressure reading but it is a little higher than it should be, and you should try to lower it.

140 over 90 (140/90) or higher (over a number of weeks): You may have high blood pressure (Hypertension). Change your lifestyle – see your doctor or nurse and take any medications they may give you.

If your top number is 140 or more – then you may have high blood pressure regardless of your bottom number.

If your bottom number is 90 or more – they you may have high blood pressure, regardless of your top number.