Blog

Life is busy. Many of my patients are so busy that they, to paraphrase Gustav Stresemann, are walking “on the edge of a volcano.” It just takes one small event to teeter over the brink. When life is this hectic, it can be easy to neglect something that isn’t causing you any symptoms. Blood pressure is just one of those things. They don’t call it the “silent killer” for nothing. High blood pressure stalks many of us from middle age without us knowing, waiting for an opportunity to push us over the edge. 

Ignoring your blood pressure in early middle age can have a compound adverse effect on your cardiovascular health. It is a bit like having debt on a credit card that you never get around to paying off but keep spending on in order to accrue the Air Miles. 

High blood pressure in middle age can have a particular impact on brain health in older age. Almost half of the burden of Alzheimer’s disease and related dementia is due to factors that are within our power to change. High blood pressure is one of the most common of these factors. 

A recent study conducted by researchers at the University of California has shed more light on the connection between blood pressure and brain health. Their findings underscore the importance of monitoring and managing blood pressure, especially in early adulthood. 

The study followed a diverse group of participants and found that individuals with hypertension (high blood pressure) or those who transitioned to hypertension in early adulthood had smaller brain volumes and poorer white matter integrity in late life. Interestingly, the negative impact of hypertension on brain volumes was more pronounced in men compared to women.

Previous research has already indicated a link between hypertension and neurodegenerative conditions such as dementia. This recent study reinforces those findings and highlights the importance of considering hypertension earlier in life, even during early adulthood. Early adulthood hypertension and increases in blood pressure were associated with differences in brain volumes and white matter integrity, which are key indicators of cognitive decline and dementia.

Notably, the study used updated guidelines for diagnosing hypertension, taking into account lower thresholds for diagnosis. This suggests that even individuals previously classified as having prehypertension or normal blood pressure could still be at risk for neurodegenerative changes associated with dementia.

The study also uncovered some interesting sex differences. Hormonal factors appear to play a role in protecting women from the detrimental effects of hypertension on the brain, particularly before menopause. Men, on the other hand, seem to experience a stronger negative association between hypertension and brain volumes. The findings of this study emphasise the critical role of managing blood pressure throughout life, starting from early adulthood.

It’s vital not to overlook the significance of blood pressure management. Just as neglecting credit card debt can result in mounting interest and financial distress, ignoring blood pressure can have a compounding effect on brain health. By regularly monitoring and managing blood pressure, particularly in middle age and early adulthood, you can take proactive steps to protect your brain health and reduce the risk of cognitive decline in later years. Consult with your doctor, make lifestyle changes, and adhere to any prescribed medications to keep your blood pressure in check. 

Dr J Hugh Coyne

Private GP

Parsons Green