Midlife Hypertension Increases Elderly Cognitive Decline

New research offers one more reason to monitor and control hypertension. People with high blood pressure in their 50s or 60s are more likely to experience lower mental performance, a common dementia precursor, in their 70s or 80s, according to a long-term analysis.

Detecting Mental Deterioration

The showed that middle-aged subjects with high blood pressure or slightly elevated prehypertension had steeper mental declines after a maximum of 23.5 years than healthy participants. Lead author Dr. Rebecca F. Gottesman, M.D., Ph.D., of the neurology department at Johns Hopkins University School of Medicine in Baltimore, Md., found that hypertension subjects were the equivalent of 2.7 years older mentally when the study began. This increased their risks of developing dementia and/or Alzheimer’s disease with earlier occurrences. Researchers launched the study with 13,476 adults between 48 and 67 years old. They divided the participants into three groups. Normal blood pressure subjects included those with readings under 120 millimeters of mercury (mm Hg) systolic and 80 mm Hg diastolic. Prehypertension participants had blood pressure up to 139/89 mm Hg. People above that reading and those taking prescription blood pressure medications comprised the hypertension group. All subjects underwent blood pressure readings with verbal, math and memory mental performance tests in 1990-1992. Over 5000 participants still were alive and available for additional investigation over the next 20 plus years. Investigators re-administered mental assessments in 1996-1998 and 2011-2013. People with hypertension at the beginning of the study were twice as likely to die by 2011 as those without it. For subjects who still were alive at the end, having high blood pressure during the first testing period lowered their final global cognitive scores by 6.5 percent. Mental decline for prehypertension subjects was in between the hypertension and normal blood pressure groups. Patients who took blood pressure medications had an intermediate mental decline, similar to those with prehypertension. Global cognition scores dropped more in Caucasians than African Americans.

Monitor Blood Pressure from Age 40

Some researchers believe that high blood pressure leads to Alzheimer’s disease directly while others contend that it causes silent strokes and other brain changes that raise dementia risk. Dr. Philip B. Gorelick of the Michigan State University College of Human Medicine in Grand Rapids supports this study’s findings that catching hypertension in middle age can help avoid waning mental abilities. At this stage, elevated blood pressure hasn’t pounded the brain on a long-term or chronic basis enough to cause irreversible brain changes that affect cognition. Gottesman concluded that midlife high blood pressure is an important predictor of mental decline. She notes that many people are unaware that their readings are elevated because hypertension doesn’t cause symptoms. So she advises keeping track of your blood pressure by age 40 or earlier if you have a family history of hypertension.

Prescription Treatment is Vital

Initiating high blood pressure treatment in old age might be too late to prevent mental deterioration, according to Gottesman. But starting medication in middle age may help avoid late-life cognitive impairment. In addition to inhibiting late-life mental decline, managing hypertension in the prime of your life can help decrease your . Your doctor may prescribe Twynsta, a high blood pressure medication that contains two drugs to ease blood flow. Amlodipine helps relax and widen your blood vessels while telmisartan prevents constriction.

Adopt Healthy Lifestyle Modifications

This study underscores the importance of midlife adults taking hypertension medications and controlling blood pressure through diet and exercise. Gorelick notes that you can expect good cardiovascular health practices to preserve your cognition. These Mayo Clinic lifestyle choices can help control your high blood pressure. Eat a healthy diet: Fill up on whole grains, fruits, vegetables and low-fat dairy products. Skimping on saturated fat and cholesterol can lower your blood pressure by up to 14 mm Hg.

• Keep a food diary. Monitoring what you eat, how much, when and why — even for just a week — can reveal your true eating habits.
• Boost your potassium. This mineral can lessen the effects of sodium on blood pressure. Choose fruit and vegetable sources over supplements.
• Be a smart shopper. Use a grocery list and read food labels to avoid junk food impulse buys.
• Cheat occasionally. Enjoy an off-limit treat such as candy only periodically to deter binges.

Reduce sodium intake: Even a small sodium reduction can reduce blood pressure by 2-8 mm Hg.Limit sodium to 2300 mg (1 teaspoon) per day. Consume 1500 mg or less if you’re over 50, an African-American of any age or have hypertension, diabetes or chronic kidney disease.

• Make a sodium diary. Estimate your daily sodium content from foods and drinks.
• Avoid sodium-heavy processed foods. Read food labels and replace potato chips, frozen dinners, bacon and processed lunch meats with low-sodium alternatives.
• Don’t add salt. Use herbs or spices to flavor your foods instead.
• Decrease sodium gradually. Your palate will adjust over time.

Limit alcohol consumption: Small amounts of alcohol can lower your blood pressure by 2-4 mm Hg potentially. But daily overindulgence can raise your blood pressure several points and reduce your hypertension medication’s effectiveness. Restrict alcohol to one drink for women and men 66 and up and two servings for men 65 and younger. Exercise regularly: At least 30-60 minutes of regular physical activity on most days can lower your blood pressure by 4-9 mm Hg.