Risk Factors: Blood Pressure
There is an overlap of risk factors between VaD and AD, so much so that it raises some serious questions about vascular contributions to AD. Recognition that cerebrovascular disease causing dementia may be modified by treatment of cerebrovascular risk factors serves as an important tool for investigating various treatments aimed at secondary prevention of vascular cognitive impairment .
The relation between hypertension, its treatment, and severe white matter lesions has been assessed in 10 European cohorts . White matter lesions in the periventricular and subcortical regions were rated separately using semiquantitative measures. Increase in systolic blood pressure levels were associated with more severe periventricular and subcortical white matter lesions. People with poorly controlled hypertension had a higher risk of severe white matter lesions than those without hypertension .
Recent works, on the contrary, underline a potential negative effect by decreasing diastolic blood pressure level on the occurrence of severe periventricular white matter lesions.
High Blood Pressure Is A Risk Factor For Cognitive Impairment And Dementia
Cognition encompasses thinking, memory, language, attention, and other mental abilities. Researchers have known for many years that if you have high blood pressure, you have a higher risk of developing cognitive impairment and dementia. However, just because high blood pressure is a risk factor, it does not necessarily mean that lowering high blood pressure will lower your risk. Many things in health and science correlate without one causing the other . Thus, randomized, double-blind, controlled studies are needed to answer this question.
Hypertension And The Risk Of Dementia
- Hypertension & Vascular Risk Unit, Internal Medicine Department, Hospital Clinic of Barcelona , University of Barcelona, Barcelona, Spain
Hypertension, particularly midlife high blood pressure, has been related to a higher risk of cognitive decline and dementia, including Alzheimer disease. However, these associations are complex and not fully elucidated. Cerebral small vessel disease emerges as one of the most important causes. Several observational studies have shown the potential beneficial role of antihypertensive treatment in preventing cognitive decline. However, randomized clinical trials have shown controversial results without proving nor disproving the association. On the other hand, in very elderly or frail people some studies have observed a relationship between low blood pressure and worse cognitive function. The optimal systolic and diastolic blood pressure values for protecting cognitive function, especially in elderly people, are not known.
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Can Controlling Blood Pressure Later In Life Reduce Risk Of Dementia
- By Andrew E. Budson, MD, Contributor
Everyone talks about the importance of treating high blood pressure, the silent killer. And everybody knows that untreated high blood pressure can lead to heart attacks and strokes. But can treating high blood pressure reduce your risk of cognitive impairment and dementia?
What Are The Signs And Symptoms Of Vascular Dementia
The effects of vascular dementia vary from person to person and depend on which parts of the brain are affected. Some common signs and symptoms include:
- difficulty remembering things, such as recent events
- struggling to concentrate
- problems thinking, for example, taking longer to find the words youre looking for and difficulty planning and organising
- feeling disorientated or confused
- being unsteady, problems walking and moving around, and falls
- sight problems and loss of spacial awareness
- changes in mood, such as feeling depressed or anxious, and having mood swings
Symptoms may stay the same for a while, then suddenly get worse. This is known as stepwise progression, and can be caused by another stroke or mini stroke. With small vessel disease, symptoms might slowly get worse.
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‘dementia Link To Sudden Low Blood Pressure And Dizziness’
People who experience frequent drops in blood pressure or dizziness when suddenly standing up are at increased risk of dementia, scientists say.
Writing in Plos Medicine they suggest that less blood reaches the brain during these moments, leading to brain cell damage over time.
Dementia experts say this is a “robust study” and “plausible explanation” that needs further investigation.
Charities point out that factors such as smoking carry higher risks.
But they say the work adds to growing evidence that changes in blood pressure have an impact on the brain.
What Is Vascular Dementia
Dementia is a group of disorders of the brain which causes symptoms including loss of memory, difficulty thinking and concentrating, and problems communicating.
Vascular dementia is the second most common type of dementia after Alzheimers disease. Its caused by problems with the blood supply to the brain. Some people with vascular dementia will have Alzheimer’s disease as well, which is known as mixed dementia.
Dementia is usually progressive, which means the symptoms tend to get worse over time, but it is possible to slow it down. There is also support available to those living with it.
This video from Alzheimers Society explains what vascular dementia is and how it develops.
Getting Your Blood Pressure Checked And Under Control
There is no harm in a person monitoring his or her blood pressure. Some people have naturally low blood pressure, and some, naturally high blood pressure. A doctor can provide a person more information regarding his or her blood pressure and what is considered normal based on health history, diet, age, etc.
If a person is informed his or her blood pressure is nothing to worry about, then it is likely anxiety related. Trying to learn healthy ways to breath can be hugely helpful in these cases. Focusing on taking slow breaths, and not trying to over-compensate for poor breathing are good places to start. Going for a walk can help as well because it can take ones mind off of whatever difficult symptoms a person is experiencing, and get his or her blood flowing.
Anxiety can cause low blood pressure through hyperventilation. Some people also find themselves with anxiety after seeing otherwise normal low blood pressure during a random fluctuation. Learning to slow down and control breathing can help, although an anxiety treatment will be more important.
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Blood Pressure As Risk Factor For Dementia
Our results also show that low blood pressure was related to vascular dementia and other dementias. This may mean that blood pressure decreases during the course of vascular and other dementias. More importantly, however, it raises the possibility that low blood pressure may predispose a subpopulation to developing dementia since relatively low blood pressure was significantly associated with dementia even when it was of shorter duration .
Another explanation for the association might be that, if we had misclassified subjects with high blood pressure as having a middle blood pressure level because of our single recording of blood pressure, people with high blood pressure or hypertension had a lower risk of developing dementia or Alzheimer’s disease while those with low or middle level of blood pressure had the same higher risk. In fact, we did find that high blood pressure was unrelated to any type of dementia.
Decreased cerebral blood flow is known to occur in both Alzheimer’s disease and vascular dementia, and the degree of reduction generally correlates with the severity of dementia. It seems possible that low blood pressure might accelerate the process of dementia by lowering cerebral blood flow. This mechanism could be reinforced by the dysfunction in autonomic nervous system observed in patients with Alzheimer’s disease. It is not known whether a reduction in blood pressure is correlated with the reduced cerebral blood flow found in dementia.
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Evidence From Randomized Clinical Trials
Most of observational studies have constantly showed that reducing high blood pressure has beneficial effects in lowering the risk of cognitive impairment and dementia .
With relation to randomized clinical trials evidence has been conflicting. Some placebo-controlled RCT evaluated the role of antihypertensive treatment for preventing cognitive deterioration, dementia and stroke-related cognitive decline . The SHEP study showed that therapy with chlortalidone in elderly individuals with isolated systolic hypertension significantly decreased the risk of stroke and CV episodes but not cognitive deterioration and dementia . In the Syst-Eur trial, individuals with isolated systolic hypertension were given medical treatment, nitrendipine, and if there was no BP control, with enalapril, or hydrochlorothiazide, or both. The study found that active treatment vs. placebo decreased dementia incidence by 50% over 2 years . People included were kept on treatment for 2 years more in an open study. Results from the continued study strengthened the initial conclusion that prolonged antihypertensive treatment with nitrendipine diminished dementia risk by 55% . In the PROGRESS trial , the risk of dementia and cognitive impairment were assessed as a secondary objective . Results exhibited no significant effect of the treatment on the risk of dementia. Results just showed that therapy significantly decreased the risk of cognitive impairment and dementia with the recurrence of strokes .
What’s The Blood Pressure Connection To Alzheimer’s Disease
Look after your heart to be kind to the mind. That’s the primary message emerging from research into Alzheimer’s, a disease of the brain that appears to be deeply driven by what happens to the heart and blood vessels.
The link between high blood pressure and Alzheimer’s disease has been a particular focus of recent studies.
“High blood pressure, uncontrolled, causes damage to virtually every organ system,” said Jeff Keller, director of the Institute for Dementia Research and Prevention at Louisiana State University in Baton Rouge. “It shouldn’t be surprising that the brain, the most vascularized and energy-dependent organ of the body, is greatly the most damaged by fluctuations in blood pressure control.”
Alzheimer’s disease is the most common cause of dementia and is the sixth-leading cause of death in the United States. About 5.7 million Americans have been diagnosed with the disease, including 200,000 people under the age of 65. Those numbers are expected to skyrocket as more Baby Boomers reach retirement age and beyond.
At the annual Alzheimer’s Association meeting in July, researchers presented preliminary findings from a study that looked at the impact of aggressively reducing high blood pressure to currently recommended levels. It found the effort decreased the risk of developing mild cognitive impairment, a common precursor to dementia.
If you have questions or comments about this story, please email .
Why Sufferers From Alzheimers Disease Might Have Lower Blood Pressure
Forgetting your troubles can bring healthier hearts
Oxford, October 14, 2008 – A new study published in Bioscience Hypotheses, a recently launched Elsevier journal, proposes that some people suffering from Alzheimers disease experience a reduction in their high blood pressure because of cognitive decline.
Publications relating to dementia and blood pressure have been reviewed by the papers author Dr Sven Kurbel of the Osijek Medical Faculty in Croatia. The cognitive problems suffered by some Alzheimers patients have previously been put down to low blood pressure . The hypothesis put forward by Dr Kurbel is that the opposite is true. He suggests that as the patients memory fails, they forget the causes of anxiety and worry that was causing high blood pressure: failing memory causes hypotension, not visa versa
Hypertension itself is a cause of disease, including strokes, so paradoxically, Dr. Kurbel’s hypothesis suggests, treatments which alleviate memory loss could affect other causes of illness. If this hypothesis is correct it could have a significant effect on the treatment of conditions such as metabolic syndrome, which involves increased weight and high blood pressure. Dr. Kurbel concludes that An important question is would reduction of stressful memories and of stress exposure in everyday life help diminish the risk of getting hypertension or metabolic syndrome in the years to come.
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Antihypertensive Therapy And Dementia
Given the association between hypertension and the development of dementia, a reasonable hypothesis is that antihypertensive therapy may protect against the development of dementia. However, the association with hypotension in later life and the risk of AD in particular, raises the possibility that this treatment may in fact contribute to the development of dementia. Several observational studies have longitudinally examined the effect of AH treatment on cognitive function and dementia .
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What Else Can Cause Vascular Dementia
Other health problemsAny health problem which affects the blood vessels can lead to vascular dementia, including high cholesterol, heart disease and diabetes.
Lifestyle The lifestyle factors which lead to high blood pressure, such as smoking and lack of physical activity, can also lead to the health problems mentioned above, and in turn lead to vascular dementia.
Other risk factorsThere are a number of risk factors for vascular dementia which cant be changed, making it more important to take care of the things you can. These factors include:
- age the risk goes up as you get older, and its uncommon in people under 65
- being male men are at a slightly higher risk that women
- stroke having had a stroke in the past
- atrial fibrillation where the heart beat is too fast or irregular
- being of South-Asian and African and Caribbean descent people with this background are at higher risk of diseases such as heart disease, diabetes and stroke
- a family history of stroke or heart disease
Low Blood Pressure In Elderly People: The Vital Facts You Should Know
Most people are aware that high blood pressure in seniors can lead to serious medical issues, but low blood pressure in elderly individuals gets far less attention. However, blood pressure that drops too low can have equally serious effects on your health. It’s important to know the facts so that you can take proper care of yourself.
A low blood pressure reading is not necessarily cause for panic. While high blood pressure is harmful even if you don’t know you have it, low blood pressure is generally not a problem unless you start experiencing symptoms like dizziness or blurred vision. If that happens, you need to take action. Symptomatic low blood pressure in the elderly can be very dangerous because it raises the risk of a fall. At its most extreme, it can lead to shock and even death.
This article explains the basic facts about blood pressure, including how it’s measured and what the measurements mean. It also describes common symptoms of low blood pressure and outlines a variety of factors that can cause such a condition. And it provides information about different ways that low blood pressure in older adults can be treated or managed.
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High Blood Pressure In Younger Adults Linked With Dementia Risk Smaller Brain Size
Results suggest that early treatment or prevention of hypertension may reduce the risk of dementia.
New research suggests that people with hypertension in their thirties and forties may have a higher risk of dementia later in life. Investigators also found that on average, people with high blood pressure had smaller brains compared with people with normal blood pressure.
These results indicate that its very important to know your blood pressure level, even in young adults, says Donna K. Arnett, PhD, MSPH, professor in the department of epidemiology at the University of Kentucky College of Public Health in Lexington, and a past president of the American Heart Association and a volunteer expert for the organization. Dr. Arnett was not involved in this research. If you are found to be hypertensive, you should seek treatment early, she adds.
Nearly Half Of Us Adults Have High Blood Pressure
Blood pressure is simply a measurement of the pressure of blood pushing against the walls of the arteries. If blood pressure stays high for a long time, it can cause damage to organs, including your heart, brain, kidneys, and eyes.
According to the Centers for Disease Control and Prevention , nearly half of adults in the United States 47 percent or 116 million people have hypertension, which is defined as a systolic blood pressure greater than 130 milimeters of mercury or a diastolic blood pressure greater than 80 mmHg or are taking medication for hypertension.
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What Does The Research Say About High Blood Pressure And Dementia
According to the World Alzheimer Report 2014, multiple studies following large groups of people for 15-40 years have demonstrated that individuals who had high blood pressure in mid-life were more likely to develop vascular dementia in later life. Vascular dementia is the second most common form of dementia after Alzheimer’s disease. It is caused by reduced blood flow to the brain, which starves brain cells of the oxygen and nutrients they need to function correctly. The association between high blood pressure and Alzheimer’s disease is currently unclear.
However, despite this apparent link between vascular dementia and high blood pressure, the results from randomised controlled trials into whether lowering blood pressure can prevent dementia have so far been inconclusive.
This research demonstrates the importance of conducting studies that follow individuals over a long period of time , to connect a person’s lifestyle choices and health profile throughout their life to the risk of disease development in later life.
Vascular Dementia Risk And Hypertension
To evaluate dementia risk, researchers tracked 124,053 people with high blood pressure to 124,053 participants with normal blood pressure for a median follow-up of 11.9 years to see who developed dementia from any cause.
In that time, a total of 4,626 people developed some form of dementia. In comparing the people with high blood pressure to those without it, investigators found the following:
- The risk of dementia from any cause was significantly higher 61 percent in people who had been diagnosed with high blood pressure between the ages of 35 and 44 years old compared to participants who did not have high blood pressure.
- The risk of vascular dementia, a type of dementia resulting from impaired blood flow to parts of the brain, was 45 percent higher in the adults diagnosed with hypertension between ages 45 and 54 and 69 percent higher in those diagnosed between ages 35 and 44, compared with participants of the same age without high blood pressure.
Although vascular dementia risk was 80 percent higher in people diagnosed with high blood pressure before age 35, there werent many cases of dementia among those younger participants, and the association wasnt statistically significant.
There was no relationship found between age at hypertension diagnosis and the risk of Alzheimers disease, a type of dementia linked to proteins that disrupt brain function.
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