Added to Favorites
Add to My Favorites
Added to My Favorites
by Candy Sagon
Updated August 5, 2022
Most people know that high blood pressure can lead to heart attacks and strokes, two very good reasons to keep it under control. But here’s another equally important reason: Treating high blood pressure may reduce your risk of cognitive decline or dementia.
Researchers have been looking at the connection between high blood pressure and brain health for decades. Studies that followed large groups of adults found that high blood pressure in middle age in particular was associated with worsening performance on mental-skills tests as participants grew older.
Research studies drive home this message: One thing older people can do to help protect their memory and thinking skills as they age is to get a handle on their high blood pressure.
“The effect of high blood pressure on the brain is cumulative. The longer you have high blood pressure, the greater the damage it does over time,” American Heart Association President Mitchell Elkind said in an interview. A professor of neurology and epidemiology at Columbia University, Elkind said researchers have known for several years “that high blood pressure is linked to cognitive decline. We can see changes in thinking ability as measured by test scores over time, as well as dementia.”
That’s because ongoing high blood pressure starts to damage the blood vessels in the brain, Elkind explained, making them more likely to rupture and bleed. “Even tiny bits of damage to the vessels, over time, adds up. It’s like [the brain’s version of] heart failure — a progressive decline in function as time goes by.”
But research suggests that treating the condition — with medication, if necessary, as well as through changes in diet and exercise — can help stave off mental decline. There are currently more than 100 million American adults with high blood pressure, yet only about 1 in 4 have their condition under control.
Researchers from the National University of Ireland Galway conducted a major study, published in May 2020 in JAMA, in which they found that lowering blood pressure by taking medication “was significantly associated with a lower risk of dementia or cognitive impairment.”
The researchers analyzed data from 14 randomized clinical trials involving more than 96,000 people (average age 69) who had an average blood pressure reading of 154/83. For most adults, a reading of below 120/80 is considered healthy.
Twelve of the trials found that participants who took medication to lower blood pressure to a healthy range reduced their risk of developing dementia or cognitive impairment by about 7 percent over a four-year period, compared with those in the control groups. “When you consider how common dementia is in the population — 50 million people worldwide — effective treatment and control of high blood pressure would have a major impact on preventing dementia,” coauthor Conor Judge said in a statement.
The 2019 “Brain-Heart Connection” report by AARP’s Global Council on Brain Health, an international collaboration of scientists and medical experts, also recommends that if your blood pressure is higher than 130/80, you should talk to your health care provider about steps to bring it under control.
Problems with blood pressure may be more common among those older than 60, but “there is overwhelming evidence that taking care of your heart is one of the most important things you can do to lower your risk of dementia and keep your brain healthy as you age,” the report states.
Other studies with similar findings include:
What you should know:
Neurologist Mitchell Elkind is a past president of the American Heart Association and a specialist in stroke prevention and other issues of brain health. In an interview with AARP, he shares the following for people dealing with high blood pressure.
• “Hypertension, Prehypertension, and Hypertension Control: Association With Decline in Cognitive Performance in the ELSA-Brasil Cohort,” Hypertension, December 2020. Researchers analyzed data from more than 7,000 adults who were part of the long-term ELSA-Brasil study. They found that people with untreated high blood pressure experienced a faster decline in cognitive function compared with those without high blood pressure or those who were taking medication to control their blood pressure. Read the full study.
• “Association of Blood Pressure Lowering With Incident Dementia or Cognitive Impairment: A Systematic Review and Meta-analysis,” JAMA, May 2020. Read the full study.
• “Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia: A Randomized Clinical Trial,” JAMA, January 2019. Read the full study.
• “Blood Pressure and Cognitive Decline Over 8 Years in Middle-Aged and Older Black and White Americans,” Hypertension, January 2019. Read the full study.
• “Antihypertensive Treatment Can Delay Cognition Decline in Middle-Aged and Older Chinese between 2011 and 2015: Results from the China Health and Retirement Longitudinal Study,” The Lancet, 2020. Read the full study. (Note: This is a preprint, which means it has not yet been peer-reviewed.)