igh blood pressure, especially in middle
age, is associated with an increased risk of
cognitive impairment later in life, according
to a statement from the American Heart
The statement, published in the American Heart
Association journal Hypertension, reviewed multiple
studies and provides an overview of what is currently
known about how high blood pressure influences brain
diseases such as stroke, vascular cognitive impairment
and Alzheimer’s disease.
“Many observational studies suggest treating
hypertension may reduce the cognitive impact of
high blood pressure, especially on vascular cognitive
impairment, but observational studies are not designed to
prove cause and effect,” said Costantino Iadecola, M.D.,
chair of the writing committee.
Vascular cognitive impairment describes a range of
changes in brain function, from mild to severe, caused by
the impaired flow of blood to the brain.
“We know treating high blood pressure reduces the
risk of heart diseases such as heart attacks, congestive
heart failure and stroke, and it is important to continue
treating it to reduce the risks of these diseases. However,
we need randomized controlled studies — which do
prove cause and effect — to determine if treating high
blood pressure, especially in middle age, will also
decrease the risk of cognitive impairment later in life,”
Most of the clinical trials the writing committee
reviewed did not directly investigate the effect of high
blood pressure on cognition, which made it impossible
to draft a statement that would give healthcare providers
guidance on how to treat patients with dementia, said
Iadecola, who is also the Anne Parrish Titzell Professor of
Neurology and director of the Brain and Mind Research
Institute at Weill Cornell Medicine.
One of the issues researchers face is that there are
years between the time a patient has high blood pressure
and when the cognitive problems arise, so long-term
studies addressing questions such as when to start
treatment aimed at protecting the brain, the level of blood
pressure that should be achieved and which medications
are recommended is difficult to pinpoint.
Dementia, one of the most common neurological
disorders, affects an estimated 30 million to 40 million
people worldwide. The number of people with dementia is
anticipated to triple worldwide by 2050 due to the aging of
the population, shifts in demography and lack of treatments,
with an associated cost exceeding $1.1 trillion.
The two leading causes of cognitive impairment are
Alzheimer’s disease and vascular cognitive impairment,
which account for approximately 80 percent of cases. Often,
patients suffering from dementia have a mixture of the two.
“The SPRINT-MIND trial, a new study that is designed
to evaluate the role of treating high blood pressure
relative to cognitive impairment, may provide answers to
some of the outstanding questions about treating high
blood pressure relative to reducing the risk of cognitive
impairment,” said Iadecola.
Until then, Iadecola recommends treating high blood
pressure on an individual basis in patients to protect
brain, heart and kidney.
Source: American Heart Association News
to the Brain
HIGH BLOOD PRESSURE AND
BRAIN HEALTH ARE LINKED