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How Does High Blood Pressure Cause Vascular Dementia
Uncontrolled high blood pressure can , making them weaker or narrower, and more likely to burst or become blocked. This restricts the blood supply to parts of the brain, so not enough oxygen and nutrients can reach the brain cells, damaging that part of the brain.
There are three main ways high blood pressure can affect the blood supply to the brain and cause vascular dementia:
- Damage to the blood vessels in the brain the blood vessels can become narrow and stiff, known as small vessel disease. This is the most common cause of vascular dementia
- Stroke a is where a blood vessel in the brain becomes blocked or bursts, cutting off the blood supply to part of the brain and causing damage. This is known as post-stroke dementia
- TIA , also known as a mini stroke a series of can gradually cause damage. This is known as multi infarct dementia
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Shyam Prabhakaran Md Ms
Shyam Prabhakaran, MD, is the Chair of the Department of Neurology at UChicago Medicine. He is an internationally recognized leader in vascular neurology and stroke research and treatment, and has led projects focused on uncovering the underlying causes of recurrent strokes, improving stroke care, and optimizing patient outcomes and recovery.
Latest High Blood Pressure News
The longer a person’s blood pressure levels remain under control, the lower their risk may be for dementia, new research shows.
The findings add to evidence suggesting that good heart and brain health is best achieved by keeping systolic blood pressure consistently under control, compared to having levels that vary, even if the average falls within the target range.
The work will be presented Saturday at the American Heart Association’s Scientific Sessions conference being held in Chicago and virtually. The findings are considered preliminary until full results are published in a peer-reviewed journal.
“This study clarified that time in target range has an incremental value beyond mean systolic blood pressure and systolic blood pressure variability,” said lead researcher Sitong Li, a doctoral student in the department of cardiology at Beijing Anzhen Hospital, Capital Medical University in Beijing. Tracking how long blood pressure is kept under control could help health care providers “identify patients at higher risk of dementia and provide individualized blood pressure interventions to help patients stay within target.”
Nearly half of U.S. adults have high blood pressure, according to AHA statistics. Of those, only about 1 in 5 have their condition under control, which can be done with regular exercise and a healthy diet, and possibly medication.
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Other Factors Related To High Bp And Risk Of Developing Cognitive Impairment
As previously mentioned, and in addition to age, various VRFs have been related to the development of a cognitive impairment , with arterial hypertension due to its importance and its prevalence being the most important . It has also been observed that the greater the number of VRFs, the greater the risk .
There are some studies that have showed that the presence of particular aspects, or some diseases, in hypertensive population confers a greater risk of cognitive impairment. This is the case of hypertensive patients with depression , or hypertensive population with a worse economic situation . In general population, many others factors such as depression, educational level, socioeconomic status , physical inactivity or unhealthy diet have also been related to the development of cognitive impairment . However, some studies are not longitudinally designed, or have short follow-up or small sample size, or the neuropsychological assessment is not complete enough. Further evidence is necessary to establish whether particular combination of some conditions confer greater risk of cognitive function impairment or if that risk is higher in hypertensive people.
Living With Vascular Dementia
There is lots of support available to help people living with vascular dementia. For example, counselling and talking therapies can help you deal with the impact on your day to day life, and physiotherapy and support from an occupational therapist can help keep you independent.
Its important to be social, stay active and do things you enjoy doing, including listening to music, art therapy, dancing, exercise. There are activities and services designed for people with dementia, for example, memory cafes, where you can meet people and get advice and support to deal with the day to day symptoms.
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How Managing Hypertension May Help
Five experts, who were not involved in this research, explained the findings and implications for patients to Medical News Today.
Dr. Anjali N Patel, DO, a fellowship-trained cognitive neurologist at the Atlantic Neuroscience Institute at Overlook Medical Center said that the SPRINT trial evaluated older adults with hypertension and one other cardiovascular risk factor such as chronic kidney disease, to determine if lowering the systolic blood pressure to 120mm Hg instead of 140mm Hg provided any benefits.
Overall, researchers found the participants had fewer heart attacks, strokes, and cardiac deaths. In reviewing the data further, researchers found lowering the target range of the blood pressure for prolonged period was associated with a lower risk of probable dementia, she told MNT.
However, Dr. Patel pointed out that in those with atrial fibrillation and hypertension, a lower target blood pressure range may increase the risk of probable dementia.
She said that, for people with hypertension, primary care physicians or cardiologists should work as a team to lay out the best goals of care tailored to the individual.
This is an important study that shows certain patients with cardiovascular risk factors can benefit from more aggressive control of their blood pressure. For example, in individuals with risk of developing a dementia disorder better management of their blood pressure may be beneficial. Dr. Anjali N Patel
Advice For Managing Blood Pressure
When asked how patients can manage and monitor their blood pressure levels, Dr. Patel highlighted that we need to be mindful regarding using these blood pressure recommendations for all patients.
The research study, for example, did not include those with diabetes and was mostly compromised of men. Risks and benefits of adding additional medication to further lower the blood pressure should be reviewed on a case-by-case basis, he said.
Dr. Tadwalkar noted the importance of lifestyle factors, telling MNT that his best advice is to vary the types of activity one does.
By performing a wide mix of exercises or activities, including those that are cardio-focused, weight-bearing in nature, balance or posture-related, mentally demanding, and those that are concerned with spiritual and emotional-centeredness, one can truly attain total body benefits. This includes less stress, greater mental clarity, better body mass index, lower cholesterol, improved glucose tolerance, and of course, more ideal blood pressure values. Dr. Rigved V. Tadwalkar
Other aspects certainly play a role, including:
- a healthy diet that emphasizes whole grains, lean or vegetarian sources of protein, healthy fats, as well as fruits and vegetables
- minimizing alcohol use
- ensuring adequate amounts of sleep
Dr. Patel agreed, saying the first line of treatment should include lifestyle modifications such as exercise, weight loss, diet, and tobacco use.
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High Blood Pressure At Any Age Can Increase Dementia Risk
- Researchers say high blood pressure at any age can increase a persons risk for dementia later in life.
- They add that the risk isnt affected by how long someone has high blood pressure.
- Experts say there are ways to reduce your risk for high blood pressure, ranging from medications to exercise to diet.
High blood pressure at any age may speed up cognitive decline.
Thats the conclusion of a study published today in the American Heart Association journal Hypertension.
Researchers say they found that even slightly elevated blood pressure in middle age or older was linked to faster cognitive decline.
We initially anticipated that the negative effects of hypertension on cognitive function would be more critical when hypertension started at a younger age, Sandhi Maria Barreto, PhD, an author of the study, said in a press release . Barreto is also a professor of medicine at the Universidade Federal de Minas Gerais in Belo Horizonte, Brazil.
However, our results show similar accelerated cognitive performance decline whether hypertension started in middle age or at older ages, she explained.
We also found that effectively treating high blood pressure at any age in adulthood could reduce or prevent this acceleration. Collectively, the findings suggest hypertension needs to be prevented, diagnosed, and effectively treated in adults of any age to preserve cognitive function.
Bring Down Blood Pressure Now
While more research investigates the brain benefits of blood pressure meds, you can play it smart by taking healthy lifestyle steps to keep blood pressure in a healthy range. Here are some of the best strategies.
Eat real.
That means nixing processed foodseven canned vegetables, which are oftenhigh in sodium. Among the most successful blood-pressure-lowering diets area Mediterranean diet or DASH .Both diets are high in fruits, vegetables,whole grains, low-fat dairy, poultry, fish and nuts, but low in harmful fats, red meat,sweets and sugary drinks. The effects can be quick, with blood pressurereductions in just two weeks.
Shed extra weight.
In one analysis of 25 clinical trials, losing an average of 11 poundsshaved 4.4 points offsystolic blood pressure and 3.6 points offdiastolic. Other studies have found that modest weight loss canprevent hypertension in overweight people, even if they dont reduce theamount of sodium in their diet.
Check blood pressure at home.
Monitoring your blood pressure at home can improve blood pressuremanagement more than just seeing your doctor. You can purchase automaticblood pressure cuffs for as little as $35 ask your doctor for arecommendation. Many pharmacies and drugstores also offer free bloodpressure readings.
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Negative Effect Of Aggressive Treatment And Exaggerated Blood Pressure Variability In Dementia
Aggressive treatment with antihypertensive medication that leads to hypoperfusion can cause hypoxia and ischemia, which directly affect the incidence of dementia. Low diastolic BP and high SBP may also increase the risk of developing dementia through cerebral perfusion.,
Another concern involves BP variability. Strict BP lowering would decrease the lowest BP, thereby causing, especially in the elderly, exaggerated BP variability , extreme dips, and postprandial hypotension., BPV was more closely associated with cognitive dysfunction than the mean ambulatory BP . Even in the elderly hypertensive patients well controlled with low 24-hours BP levels, exaggerated weighted SD of 24-hours BP was closely associated with cognitive dysfunction.
How Can I Control My Blood Pressure
There are things you can do to lower your blood pressure if it is too high. One way is through a series of lifestyle changes that include losing weight, exercising regularly, maintaining a healthy diet that is low in salt, reducing caffeine and alcohol consumption, and quitting smoking. Alternatively, high blood pressure can be controlled through the use of blood pressure medication, which is prescribed by your doctor. These blood pressure lowering drugs have been shown to be safe and effective. However it is important to note that they have not been proven or recommended to directly prevent vascular dementia. There is a great deal of research into finding potential therapies that may be able to slow down or prevent development of vascular dementia.
If you have high blood pressure, it is important to talk to your doctor before attempting any lifestyle changes or trying new medication so they can provide you with personalised recommendations and monitor your progress.
A key take away message from these longitudinal research studies is that a life-long approach to health is important. Keeping blood pressure levels normal is only one factor, along with exercise, diet, smoking, and alcohol consumption that is important to consider when attempting minimising your risk of developing dementia. High blood pressure does not give you any symptoms initially so it is important to be proactive and find out what your blood pressure is.
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