Dizziness upon standing may be linked to dementia risk

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When some people stand up from sitting or lying down, they may feel dizzy or even faint due to a sudden drop in blood pressure.

This phenomenon is more common in older adults and is known as orthostatic hypotension. Recent research has hinted at a connection between orthostatic hypotension and dementia, though scientists have been unsure of the details.

However, a new study, published in the American Heart Association journal Hypertension, sheds light on this connection.

It suggests that the drop in blood pressure within the first minute after standing up is strongly associated with the development of dementia.

Study Reveals Early Blood Pressure Drop and Dementia Risk

Dr. Yuan Ma, an assistant professor of epidemiology at Harvard’s T.H. Chan School of Public Health, led this study.

Researchers used data collected since the late 1980s from the Atherosclerosis Risk in Communities Study (ARIC).

During the initial visit, participants had their blood pressure checked while lying down and then five times within the first two minutes after standing up.

The study included 11,644 participants, with an average age of 55 at the beginning of the study. Approximately one in five participants developed dementia, with an average time of 26 years later.

The Connection: Early Blood Pressure Drop and Dementia

The study found that participants who felt dizzy when standing up had significant drops in their systolic blood pressure (the top number in a blood pressure reading) during the first minute of standing.

Those whose systolic blood pressure dropped by 20 mmHg or more within the first 30 seconds of standing had a 22% higher risk of developing dementia compared to those with stable blood pressure. Drops in blood pressure after the first minute had a weaker impact.

Dr. Ma emphasized the importance of paying attention to these early blood pressure drops. Doctors should consider them as potential signs of a higher risk of dementia.

However, she also cautioned that the study’s design does not allow for drawing causal conclusions about whether the early drop in blood pressure leads to dementia or the other way around.

Exploring the Mechanism Behind Rapid Blood Pressure Drops

Researchers are eager to understand what happens in the brain when blood pressure rapidly drops upon standing.

Dr. Ma explained that a healthy individual’s system should be able to maintain relatively stable blood pressure, even when changing positions.

While some drop in blood pressure is expected when transitioning from lying down to standing up, it should not be a large, rapid drop. The reasons behind this rapid drop, which increases with age, remain a subject of investigation.

The Importance of Detecting Orthostatic Hypotension

Dr. Costantino Iadecola, a neurologist and director of the Feil Family Brain and Mind Research Institute at Weill Cornell Medicine, emphasized the need for healthcare professionals to check for orthostatic hypotension in their patients.

If a patient reports feeling dizzy, doctors should investigate changes in blood pressure when standing. Severe drops in blood pressure within one minute of standing should raise concerns and prompt appropriate treatment.

For older individuals already experiencing cognitive issues or balance problems, orthostatic hypotension adds to the risk of falls, fractures, and even death. People should be cautious of their surroundings and take steps to prevent accidents.

Preventing Falls and Reducing Dementia Risk

To prevent falls, the National Institute on Aging recommends strength and balance exercises, installing night lights and grab bars in the home, and using assistive devices like canes or walkers if necessary.

For those with orthostatic hypotension, the American Heart Association suggests wearing compression stockings, leg exercises while standing, and working with a healthcare provider to adjust medications that may worsen the condition.

Furthermore, Dr. Ma highlighted that changes in the brain leading to conditions like Alzheimer’s disease can begin years before symptoms appear. Therefore, minimizing cardiovascular risk factors throughout life is crucial.

These factors include not smoking, staying physically active, maintaining a healthy weight and diet, getting sufficient sleep, and keeping blood sugar, cholesterol, and blood pressure under control.

In conclusion, this study emphasizes the importance of monitoring early blood pressure drops when standing as a potential risk factor for dementia.

It also underscores the need for healthcare providers to assess orthostatic hypotension in patients, particularly in older individuals.

Ultimately, maintaining a heart-healthy lifestyle throughout life can help reduce the risk of both cardiovascular disease and dementia. Remember, what’s good for the heart is good for the brain.

If you care about dementia, please read studies about low choline intake linked to higher dementia risk, and how eating nuts can affect your cognitive ability.

For more information about brain health, please see recent studies that blueberry supplements may prevent cognitive decline, and results showing higher magnesium intake could help benefit brain health.

The research findings can be found in the journal Hypertension.

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