By Megan Brooks
NEW YORK-Keeping blood pressure in check in mid-life and avoiding low BP in late life both appear linked to a lower risk of developing dementia, according to two new studies.
“While an opportunity exists for blood pressure modification in the prevention of dementia, earlier, midlife management may be optimal, and later blood pressure-lowering interventions require careful monitoring for the potential cognitive harm associated with late-life hypotension,” Dr. Shyam Prabhakaran, chair of neurology at the University of Chicago, writes in an editorial published with the studies online today in JAMA.
“It is imperative that these nuanced effects of blood pressure on brain health inform future therapeutic approaches to prevent dementia,” he notes.
Dr. Keenan Walker from Johns Hopkins University and colleagues used the population-based, prospective Atherosclerosis Risk in Communities (ARIC) study to investigate the association of midlife to late-life BP patterns with subsequent development of dementia.
A total of 4,761 adults had BP measurements taken over 24 years at five visits and underwent neurocognitive testing during the fifth and a sixth visit, when 516 new cases of dementia were diagnosed.
Compared with normal BP, hypertension (BP>140/90 mm Hg or use of BP-lowering medication) in midlife (ages 54 to 63 years) was associated with higher risk of late-life dementia (hazard ratio, 1.41; 95% confidence interval, 1.17 to 1.71).
Risk of dementia in late-life was also increased in those with midlife hypertension followed by late-life hypotension (BP
“These findings support previous work which has demonstrated that individuals who have chronic hypertension or elevated blood pressure spanning multiple decades from middle- to late-life have an increased risk for dementia,” Dr. Walker told Reuters Health by email. “However, these findings also add to the literature by showing that individuals with a pattern of midlife hypertension that is followed by late-life hypotension (or a significant drop in blood pressure) also show an increased risk for later dementia.”
“The current study suggests that maintaining a healthy blood pressure throughout midlife and late-life may be one way to help decrease one’s risk of dementia,” said Dr. Walker.
In the other study, Dr. R. Nick Bryan from University of Texas at Austin and the SPRINT MIND investigators evaluated ties between intensive between BP lowering and cerebral white matter lesion and brain volumes in a subgroup of 449 participants from the SPRINT MIND study who underwent baseline and follow-up MRI.
Over nearly four years of follow up, intensive BP management to a target of
However, intensive BP lowering …read more
Source:: Daily Times