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I talk a lot about high blood pressure. Why? Of all the things modern medicine has to offer, treatment for high blood pressure is right up there with penicillin, smallpox vaccinations and the reduction of smoking, eating more fruits and vegetables, wearing seat belts, etc.
We’ve gained 10 years of extra life since JFK was president and doubled our life expectancy since 1900. Wow!
But with that longer life comes an increase in memory problems and dementia. How to prevent it is why I found an article in Network Open, a peer-reviewed publication from the Journal of the American Medical Association, so frightening. A study has shown that high blood pressure in your 30s is associated with worse brain health in your 70s, with men more likely to be affected than women.
Why is that frightening? Because many in their 30s don’t know they have high blood pressure, don’t want to take pills or make lifestyle changes if they do have it, and don’t think of the consequences.
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I remember my 30s — starting a family, working as a physician in a busy practice, doing all sorts of stuff. When did I go to a doctor? Pretty much never, unless I had to. I was like a lot of others, just going to the doctor when I had problems, maybe once every five years.
Now, women are different. They need to go to the doctor more often for pap smears and perhaps birth control. But guys, well, they just tend to blow it off. I was like everyone else.
So let’s unpack this study to see what we have. It was a good study, well-grounded, published by a group of researchers from the University of California, Davis. That’s important, because too many studies are junk. The studies they quote in those ads for drugs they say make you think clearly are all junk.
High blood pressure, or hypertension, is blood pressure that is higher than 130/80 mmHg. The Centers for Disease Control and Prevention estimates 47% of adults in the United States have hypertension. The rate of high blood pressure varies by sex and race. About 50% of men have high blood pressure, compared to 44% of women.
The researchers looked at data from 427 participants in the Kaiser Healthy Aging and Diverse Life Experiences study and the Study of Healthy Aging in African Americans. They obtained at least two blood pressure readings from when the participants were between the ages of 30 to 40, looking at who had high blood pressure when they were young, whether they were treated, and whether they developed high blood pressure when they were older.
Then they took MRI images of the older adults who’d had high blood pressure between ages 30 and 40, comparing them with those who’d had normal blood pressure at that age. What they saw shocked them.
The researchers found the high blood pressure group had significantly lower regional brain volumes and worse white matter integrity. Both factors are associated with dementia. They also found other negative brain changes, such as decreased grey matter volume and frontal cortex volume.
So let’s put this all together in a larger perspective.
Dementia, as I’ve said, is a big issue. There undoubtedly are factors not under our control, such as Lewy Body Dementia, which is often accompanied by Parkinsonism. But small stroke dementia, which may be in part caused by loss of brain volume, may be preventable. While this study shows that dementia is not inevitable in younger adults who have untreated high blood pressure, it does show untreated high blood pressure in early adulthood adversely affects your brain when you’re older, and that in turn puts you at risk for dementia.
My spin: In one way, this is a no-brainer. We know taking care of your body when you’re younger makes your body healthier when you’re older. It’s not the only variable that determines your health when you age, but it is the modifiable variable you can act to control.
This study shows if you have high blood pressure when you’re in your 30s and 40s and don’t treat it — change your lifestyle or take medications for high blood pressure, if those changes aren’t enough — then you’re at risk for brain damage when you age.
Who wants brain damage? Nobody. So get your blood pressure checked regularly. You can buy a good home unit. I like the Omron arm units that cost $35. And if your blood pressure is up, change your life and take the cure. Your brain will love it. Stay well.
This column provides general health information. Always consult your personal health care provider about concerns. No ongoing relationship of any sort is implied or offered by Dr. Paster to people submitting questions. Any opinions expressed by Dr. Paster in his columns are personal and are not meant to represent or reflect the views of SSM Health.
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