Blood Pressure and Cognition

 

How blood pressure affects cognition—the ability to think, remember, and reason—is less well understood than its effect on the risk for heart disease and stroke. Observational studies show that having high blood pressure in midlife—the 40s to early 60s—increases the risk of cognitive decline later in life. In old age, the impact of hypertension is not so clear. The blood flow that keeps the brain healthy can, if reduced or blocked, harm this essential organ and uncontrolled high blood pressure plays a part in this damage

One study of over 9,000 people aged 50 or older found no difference in indicators of "probable dementia" between those treated with medication to lower systolic blood pressure to less than 140 and those who's blood pressure was lowered to 120 or less. 

But after decades of observational research, there’s general agreement that high blood pressure in middle age is a risk factor for later-life cognitive decline, including overall cognition, memory and processing speed. These and other studies are consistent with the conclusion that controlling blood pressure in midlife might help maximize the potential for protecting brain function later in life. Despite this observational evidence, clinical trials—the gold standard of medical proof—have not shown that controlling high blood pressure through specific drugs or lifestyle changes can prevent cognitive decline or Alzheimer’s dementia.

So what should you do?

Do everything that you can to achieve a systolic blood pressure of 120 or lower. This clearly reduces your risk for heart disease and stroke and may yet prove to be somewhat protective against dementia in later life as well.