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Blood Pressure And Your Brain

Blood Pressure And Your Brain | Weekly Bulletins | Andrew Weil, M.D.
1 min

The goal is to keep the top number (systolic) of your blood pressure below 120 mm hg, according to the results of a clinical trial with more than 9,300 participants. The patients enrolled in the study were age 50 or older and deemed at high risk for cardiovascular disease. The study didn’t find that keeping blood pressure that low reduced the risk of dementia itself, but it did cut the risk of mild cognitive impairment (MCI), a change associated with dementia. People with MCI have more problems with cognition, thinking, remembering and reasoning than is normal at their age. High blood pressure is a leading risk factor for heart disease, stroke and kidney failure and research increasingly suggests that it also may increase the risk for dementia. Participants in the trial were randomly assigned to lower their blood pressure to less than 120 or less than 140 mm hg. The trial was designed to run for five years but ended early, after just 3.3 years, when results showed that lowering blood pressure below 120 mg hg reduced cardiovascular events including heart attacks, strokes and deaths more quickly and powerfully than did lowering it to below 140 mg hg. Even though the differences in interventions were discontinued, the researchers followed participants for the full five years to better assess the effects of lowering blood pressure on the risks of developing dementia or MCI.

My take? Normal, healthy blood pressure is defined as less than 120 over less than 80. The significance of the trial described above became apparent in 2016 when researchers reported that more than 100,000 deaths could be prevented annually if adults at risk for heart disease could reduce their systolic blood pressure to 120 or lower. The evidence that blood pressure control can help reduce MCI is an important finding.

Source:
Jeff D. Williamson et al, “Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia: A Randomized Clinical Trial,” JAMA, January 28, 2019, doi:10.1001/jama.2018.21442

Also in this week’s bulletin:

  • Work Stress And Women’s Weight
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  • This week’s recipe: Spaghetti Squash Casserole

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