Dementia linked to high blood pressure years earlier

PITTSBURGH, Jan. 12 — High blood pressure may put women at greater risk for dementia later in life by increasing white matter abnormalities in the brain, report researchers from the University of Pittsburgh Graduate School of Public Health in a study published online in the Journal of Clinical Hypertension.

“Hypertension is very common in the U.S. and many other countries, and can lead to serious health problems,” said Lewis Kuller, M.D., Dr.P.H., professor of epidemiology, University of Pittsburgh Graduate School of Public Health. “Proper control of blood pressure, which remains generally poor, may be very important to prevent dementia as women age.”

The study, part of the multisite and long-term Women’s Health Initiative Memory Study (WHIMS), included 1,424 women 65 or older who had their blood pressure assessed annually and underwent magnetic resonance imaging (MRI) of the brain. Researchers assessed white matter lesions, which are associated with increased risks for dementia and stroke. White matter makes up 60 percent of the brain and contains nerve fibers responsible for communication among the brain’s regions.

Women who, at the start of the study, were hypertensive, meaning a blood pressure of 140/90 or higher, had significantly more white matter lesions on their MRI scans eight years later than participants with normal blood pressure. Lesions were more common in the frontal lobe, the brain’s emotional control center and home to personality, than in the occipital, parietal or temporal lobes.

“Women should be encouraged to control high blood pressure when they are young or in middle-age in order to prevent serious problems later on,” said Dr. Kuller. “Prevention and control of elevated blood pressure and subsequent vascular disease in the brain may represent the best current preventive therapy for dementia.”

Co-authors of the study include Karen L. Margolis, M.D., Health Partners Research Foundation, Minneapolis; Sarah A. Gaussoin, M.S., and Jeff Williamson, M.D., Wake Forest University School of Medicine; Nick R. Bryan, M.D., University of Pennsylvania; Diana Kerwin, M.D., Northwestern University; Marian Limacher, M.D., University of Florida; Sylvia Wassertheil-Smoller, Ph.D., Albert Einstein College of Medicine; and Jennifer G. Robinson, M.D., M.P.H., University of Iowa.

The research was funded by grants from the National Institutes of Health’s National Heart, Lung, and Blood Institute and the U.S. Department of Health and Human Services.

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