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Can controlling blood pressure later in life reduce risk of dementia? – Harvard Health Blog



Everyone talks in regards to the significance of treating hypertension, the “silent killer.” And everyone is aware of that untreated hypertension can result in heart attacks and strokes. But can treating hypertension scale back your threat of cognitive impairment and dementia?

High blood strain is a threat issue for cognitive impairment and dementia

Cognition encompasses considering, reminiscence, language, consideration, and different psychological skills. Researchers have recognized for a few years that when you’ve got hypertension, you have got the next threat of creating cognitive impairment and dementia. However, simply because hypertension is a threat issue, it doesn’t essentially imply that decreasing hypertension will decrease your threat. Many issues in well being and science correlate with out one inflicting the opposite (my favourite is the correlation between the drop in birth rate and the decline in the stork population). Thus, randomized, double-blind, managed research are wanted to reply this query.

Prior research haven’t supplied clear solutions

There have, in truth, been a whole lot of these research. The most up-to-date related research is the SPRINT-MIND study, designed to measure the consequences of decreasing hypertension on dementia and/or delicate cognitive impairment. This research was so profitable at decreasing the chance of delicate cognitive impairment by decreasing hypertension that it ended early, as a result of the information and security monitoring board felt that it was unethical to proceed the management group. However, the dementia endpoint had not but reached statistical significance — doubtless due to this early termination. Thus, whereas the research succeeded in a single sense, it in the end concluded that treating systolic blood strain to under 120 mmHg (versus decrease than 140 mmHg) didn’t scale back threat of dementia.

A brand new evaluation of many research

Because SPRINT-MIND and plenty of different prior research haven’t clearly proven whether or not decreasing our hypertension can scale back our threat of cognitive impairment and dementia, meta-analyses are wanted to reply this query. Researchers in Ireland checked out data from 14 studies comprising virtually 100,000 individuals, adopted over a median of more than 4 years. They discovered that older people (common age 69) who lowered their blood strain are barely much less more likely to develop dementia or cognitive impairment (7.0% versus 7.5%). Thus, the reply is: Yes! Lowering hypertension will decrease our threat of dementia and cognitive impairment.

The relationship between hypertension and dementia

So, how does decreasing hypertension scale back our threat of cognitive impairment and dementia? Most individuals who have dementia don’t have only a single trigger. Two or even three different problems within the mind trigger their cognitive impairment and result in their decline in perform. One study estimates that the fraction of dementia threat attributable to cerebrovascular illness — that’s, strokes — was almost 25% in individuals who developed important reminiscence loss late in life. These researchers additionally discovered that the dementia threat attributable to Alzheimer’s illness was significantly increased, almost 40%.

My studying of the literature is that decreasing blood strain reduces dementia threat as a result of it reduces the chance of stroke. It’s the strokes — not hypertension by itself — that trigger cognitive impairment. Note, nevertheless, that the strokes could also be so tiny that one doesn’t even know that they’ve them. But creating a whole lot of these tiny strokes (or just a few huge ones) will tremendously improve our threat of dementia.

Optimal blood strain for optimum mind well being

Okay, however what’s thought of a wholesome blood strain from the attitude of the mind? The SPRINT-MIND research solutions that query: individuals are much less more likely to develop delicate cognitive impairment if their systolic blood strain is decrease than 120 mm Hg in comparison with the management situation of between 120 and 140 mm Hg. Thus, for optimum mind well being, it’s greatest to maintain your systolic blood strain under 120 mm Hg — at the least in keeping with the SPRINT-MIND research.

The backside line

The take-home message is obvious: You can reduce your risk of cognitive impairment and dementia by decreasing your systolic blood strain to lower than 120 mm Hg, ideally with cardio train, a Mediterranean diet, and a wholesome weight, and by including medicines if these way of life modifications alone will not be ample.


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