High Blood Pressure and Memory Loss: What’s the Link?

Bringing your numbers down can benefit your brain

Christine Richmond

Updated March 28, 2025

A woman getting her blood pressure checked at a doctor's office

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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.

Researchers have been looking at the connection between high blood pressure and brain health for decades. Ongoing high blood pressure may damage the blood vessels in the brain, making them more likely to rupture and bleed, or to harden and cause blockages, says Mitchell Elkind, M.D., chief clinical science officer at the American Heart Association and a professor of neurology and epidemiology at Columbia University. “Even tiny bits of damage to the vessels, over time, add up. It’s like the brain’s version of heart failure — a progressive decline in function as time goes by,” Elkind says.

For most adults, a blood pressure reading below 120/80 is considered healthy. Yet about 75 percent of adults age 60 and older have high blood pressure, according to the Centers for Disease Control and Prevention. Yet, only about 1 in 4 have their condition under control. But there’s good news: Research has found that treating high blood pressure — with medication, if necessary, as well as through changes in diet and exercise — can help protect your memory and thinking skills as you age.

In the SPRINT MIND trial, a study of 9,361 adults with high blood pressure ages 50 and older that was funded by the National Institutes of Health and reported in JAMA in 2019, lowering blood pressure was linked to a reduced risk of mild cognitive impairment, or MCI. Participants who lowered their systolic blood pressure (the top number, which measures the pressure against your artery walls when your heart beats) to 120 or less for an average of 3.34 years reduced their risk of MCI by 19 percent.

And this protection against memory loss was still in effect an average of seven years after the first study ended, when participants went through another round of cognitive testing. These follow-up findings suggest that “controlling blood pressure earlier in life likely has a long-term benefit,” says lead author Jeff Williamson, M.D., professor of gerontology and geriatric medicine at Wake Forest School of Medicine. The new research was reported in 2025 in Neurology.

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Importantly, 30 percent of participants in the SPRINT trial were Black and 11 percent were Hispanic. “The patients in SPRINT were highly representative of our nation, and blood pressure control was effective across all groups,” Williamson says. “This is especially important to Black Americans because high blood pressure is far more common in Black people, as are the complications of high blood pressure, including memory impairment and dementia.”

A study in China also showed the benefits of blood pressure control for brain health. In the study of 11,671 adults with an average age of 59, researchers tested blood pressure and cognitive function in 2011 and 2013, then tested cognition again in 2015 and 2018. People with a blood pressure of 140/90 or higher had a significantly greater risk of cognitive decline than people with healthy blood pressure readings. Importantly, the risk dropped if people controlled their high blood pressure with medication, as reported in 2024 in Alzheimer’s Research & Therapy.

The bottom line, Williamson says, is that any amount of blood pressure lowering at any age “is likely to benefit your brain.”

What you should know:

Keep tabs on your blood pressure at home. People who use home blood pressure monitors maintain better control of their blood pressure numbers than those who don’t, says Elkind, possibly because blood pressure can be checked more regularly and in a less stressful environment.
Get a more accurate reading at the doctor’s office. Elkind offers these tips, which really apply to both home and office readings. Make sure your bladder is empty, so you’re not tense and clenching your muscles. Don’t drink a caffeinated beverage within 30 minutes of an office visit. The blood pressure cuff should not be placed over heavy clothing, such as a sweater, as that can affect the reading. Rest your arm at about heart level during the reading — don’t let it dangle. If your reading is unusually elevated, retake it in five or 10 minutes, to be sure it’s accurate.