High Blood Pressure Variability May Raise Your Risk of Dementia

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New research suggests that big swings in blood pressure later in life may raise your risk of dementia. andresr/Getty Images
  • A study has found that high BPV was linked with increased dementia risk later in life.
  • However, the same association was not seen with BPV in midlife.
  • BPV could be thought of as an indicator of problems that lead to poor brain blood flow.
  • Problems with blood supply to the brain are linked with the development of dementia.
  • A healthy lifestyle can help reduce dementia risk.

A new study just published in JAMA Network Open reports that having a high BPV (blood pressure variability) later in life was correlated with a higher lifetime risk for dementia.

However, this was not true for people who had high BPV in midlife.

There is a large and growing body of evidence suggesting that BPV is an independent risk factor for cardiovascular disease as well as the illness and death associated with high blood pressure itself.

It has been found that BPV is linked to organ damage in blood vessels, kidneys, and the heart.

The authors state that midlife high blood pressure has additionally been linked with dementia risk. Also, lowering blood pressure may reduce that risk.

Their goal with the current study was to observe how visit-to-visit BPV at different ages was associated with lifetime dementia risk.

How high BPV in later life may be linked to increased dementia risk

The study included 820 people who were followed from the time they entered the study until their death.

People without dementia aged 65 and older were included.

Data were collected from 1994 through November 2019.

The study participants were assessed at the beginning of the study and at two-year intervals.

One measurement of systolic blood pressure per year was included in the analysis by using participants’ medical records starting from the age of 50.

Systolic blood pressure is the top number of blood pressure readings. It indicates how much pressure there is against the artery walls when the heart contracts and pumps out blood.

Visit-to-visit BPV was calculated per age-decade (for example, 50-59 years.)

At each visit, study participants were also given a cognitive abilities screening, and scores less than 86 points triggered a full evaluation for dementia.

Those who received a dementia diagnosis were then followed for one year in order to verify their diagnosis.

Autopsies were performed after death on those who had consented to the procedure.

After analyzing the data, the researchers concluded that high BPV in later life was correlated with a higher lifetime risk for dementia.

In fact, they found that year-by-year BPV calculated over the preceding 10 years was linked with a 35% higher risk for developing dementia — but only in those people who were 90 years of age.

They noted that BPV may not be a viable prevention target in middle-aged individuals.

Why might high BPV increase dementia risk?

Dr. J. Wes Ulm, a medical researcher and bioinformatics expert affiliated with the U.S. Department of Health and Human Services, said that BPV is a “multilayered phenomenon” related to several different factors, including short-term stress, exercised-induced effects on circadian rhythms, “hardening of the arteries,” and errors in the use of high blood pressure medications.

“Since BPV can be associated with pathological developments in the body,” said Ulm, “in particular arterial stiffening or prolonged environmental stressors, it has also been associated in some studies with increased risk of cardiovascular and other disease classes, although the exact relationship remains unclear and a subject of ongoing extensive study.”

Ulm went on to say that BPV has, for similar reasons, been suspected of being a potential marker for an elevated risk of dementia.

“Although dementia ensues from pathophysiological (disease-causing) changes within neural circuitry of the brain,” he explained, “the highly active metabolic state of the central nervous system (CNS) requires a reliable and adequate blood supply to fend off cumulative damage and ensure optimal cognitive functioning.”

So, insufficient blood delivery to the central nervous system is associated with dementia, in particular vascular dementia, he said.

Ulm noted, however, that the link between blood pressure and dementia remains “somewhat murky.”

“Although hypertension (high blood pressure) and poor blood pressure control in particular have often been connected with an elevated risk of dementia, not all studies have been on board with this conclusion,” he said.

The same could be true for the link with BPV, he added, noting that BPV, in a sense, could be looked at as a measurable index of physiological processes that contribute to inadequate blood circulation in the brain, such as poor blood pressure control and “hardening of the arteries.”

What people can do to reduce risks associated with BPV

According to Amber Dixon, a dietitian and the CEO of Elderly Guides, reducing the risks associated with BPV involves maintaining a healthy lifestyle that is conducive to stabilizing blood pressure.

“This includes regular physical activity, a balanced diet low in salt and high in fruits and vegetables, moderation in alcohol consumption, and avoidance of smoking,” she explained.

Regular health check-ups are also important, according to Dixon. This enables you to keep an eye on your blood pressure so that you can take steps to control it early on if it becomes necessary.

“In addition to these general measures, dealing with stress effectively is crucial as stress can cause fluctuations in blood pressure,” said Dixon. “Techniques like mindfulness, yoga, or even simple breathing exercises can help manage stress levels.”

Finally, Dixon said that medication adherence is a vital part of controlling your risk.

“Those prescribed medication to control their blood pressure should ensure they’re taking it as directed by their healthcare providers,” she advised.

Takeaway

According to a new study, high BPV was associated with an increased risk for dementia in older adults. However, the same link was not seen in midlife.

Experts say BPV could be viewed as an indicator of processes that lead to poor blood circulation in the brain, which has been linked to the development of dementia.

To reduce your risk, it is important to live a lifestyle that keeps blood pressure stable.

This includes getting adequate exercise, eating a balanced diet, consuming alcohol in moderation, avoiding smoking, and keeping stress in check. It is also vital to take any medications that are prescribed for you.

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