A recent study by scientists at the University of Miami highlights the importance of the lower number in a blood pressure reading, known as diastolic blood pressure, in assessing brain health.
This measure could help predict the presence of small scars in the brain, called white matter lesions, which are linked to an increased risk of dementia, strokes, and falls.
Blood pressure readings consist of two numbers. The top number, systolic blood pressure, measures the pressure on artery walls when the heart beats. The bottom number, diastolic blood pressure, measures the pressure on artery walls when the heart is at rest between beats.
A diastolic reading of 80 or higher is considered high, according to guidelines from the American College of Cardiology and the American Heart Association (AHA).
While systolic blood pressure is often seen as the key indicator of heart disease risk, this study suggests that diastolic pressure also deserves attention.
The researchers investigated the relationship between blood pressure and the size and location of white matter lesions in the brain.
These lesions, visible on MRI scans, are scars in the brain’s white matter, a network of nerve fibers that transmit messages involved in movement, sensation, and thinking. Lesions can disrupt these messages, leading to difficulties with balance, memory, and cognitive function.
The study included 1,205 adults aged 50 and older. The researchers found that people with lower diastolic blood pressure—below 80—had fewer white matter lesions than those with higher diastolic blood pressure.
For example, those with readings below 80 had smaller lesions in three specific brain regions compared to those with readings above 90. This finding builds on earlier research showing that high systolic blood pressure is associated with narrowed arteries that contribute to these lesions.
The location of these lesions matters, as different parts of the brain are supplied by different blood vessels. Lesions in certain regions, like the periventricular area, are particularly concerning because they are more strongly linked to problems with thinking and memory.
By age 60, 10% to 20% of people have white matter lesions, and they are almost universally present in adults over 90, according to the AHA.
The study emphasizes the importance of knowing your blood pressure numbers and discussing them with a doctor. High diastolic blood pressure, even when not accompanied by high systolic pressure, could signal a higher risk of brain-related problems.
Adjusting blood pressure levels with the right treatment might help reduce the formation of white matter lesions and their associated risks.
This research, led by Michelle R. Caunca and published in the journal Stroke, sheds light on the need to consider both systolic and diastolic blood pressure in managing overall health and preventing future brain damage.
It reinforces the value of regular blood pressure checks and personalized care for better long-term health outcomes.
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