High blood pressure in midlife may increase brain damage

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In a new study, researchers found that higher than normal blood pressure is linked to more extensive brain damage in the elderly.

They found that there was a strong association between diastolic blood pressure (the blood pressure between heartbeats) before the age of 50 and brain damage in later life, even if the diastolic blood pressure was within a healthy range.

In the study, the team used data from 37,041 participants enrolled in UK Biobank.

They looked for damage in the brain called “white matter hyperintensities” (WMH). These show up on MRI brain scans as brighter regions and they indicate damage to the small blood vessels in the brain that increases with age and blood pressure.

WMH is linked to an increased risk of stroke, dementia, physical disabilities, depression and a decline in thinking abilities.

The team found the brain damage was strongly linked to current systolic blood pressure, but the strongest association was for past diastolic blood pressure, particularly when under the age of 50.

Any increase in blood pressure, even below the usual treatment threshold of 140 mmHg for systolic and below 90 mmHg for diastolic, was linked to increased brain damage, especially when people were taking medication to treat high blood pressure.

Among the top 10% of people with the greatest brain damage, 24% of the damage could be attributed to having systolic blood pressure above 120mmHg, and 7% could be attributed to having diastolic blood pressure above 70mmHg.

The study showed that diastolic blood pressure in people in their 40s and 50s is associated with more extensive brain damage years later.

This means that it is not just the systolic blood pressure, the first, higher number, but the diastolic blood pressure, the second, lower number, that is important to prevent brain tissue damage.

Many people may think of hypertension and stroke as diseases of older people, but the results suggest that if they would like to keep a healthy brain well into our 60s and 70s, they may have to make sure their blood pressure, including the diastolic blood pressure, stays within a healthy range when we are in our 40s and 50s.

The finding also suggests that even slightly elevated blood pressure before it meets the criteria for treating hypertension has a damaging effect on brain tissue.

To ensure the best prevention of brain damage in later life, control of diastolic blood pressure, in particular, may be required in early midlife, even for diastolic blood pressure below 90mmHg, whilst control of systolic blood pressure may be more important in late life.

If you care about high blood pressure, please read studies about both numbers in blood pressure can predict heart disease, stroke and findings of this high blood pressure drug may help treat dementia and Parkinson’s.

For more information about high blood pressure treatment and prevention, please see recent studies about a better way to choose the right high blood pressure drug for you and results showing that calcium and magnesium in drinking water may lower blood pressure.

The study is published in the European Heart Journal. One author of the study is Dr Karolina Wartolowska.

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