Scientists from University College London found high blood pressure and large increases in blood pressure in midlife may be associated with brain pathologies in later life.
The study suggests that high blood pressure may lead to reductions in brain volume and higher levels of white matter hyperintensities within the brain (white matter brain lesions).
High blood pressure is known to increase the risk for cognitive impairment later in life, but exactly how and when it increases risk is unclear.
In the study, the team examined 502 participants from the Insight 46 birth cohort (born in Britain in one week in 1946) who were cognitively healthy at the age of 70 and were enrolled in the study.
The researchers measured each participant’s overall brain volume at about 70 years of age, along with the volume of the hippocampus, the extent of white matter brain lesions, the amount of beta-amyloid plaques, and cognitive capabilities.
The team tracked blood pressure from ages 36-69 to explore its influence on the brain and found that the link may be there from a younger age than anticipated.
They found that higher and rising blood pressure between the ages of 36 and 53 had the strongest associations with smaller brain volume and increases in white matter brain lesions in later life.
They speculate that these changes may, over time, result in a decline in brain function for example impairments in thinking and behavior, so making the case for targeting blood pressure in mid-life, if not earlier.
There was however no evidence that blood pressure affected cognition or the build-up of beta-amyloid plaques.
This suggests that associations between midlife blood pressure and late-life brain health are unlikely to be occurring through the build-up of beta-amyloid, which is thought to be one of the earliest changes seen in Alzheimer’s disease.
The study suggests that the fourth to sixth decades of life could be a sensitive phase when higher blood pressure and increases in blood pressure have a particular impact on the future health of the brain.
The authors believe that routine blood pressure measurement may need to start at, or before, 40 years old, and that different approaches to blood pressure change may be needed at different ages.
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The research was published in The Lancet Neurology and conducted by Professor Jonathan M Schott et al.
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