white coat hypertension, blood pressure, blood pressure measurement, blood pressure and dementia, highly variable blood pressure, high blood pressure

When scientists try to figure out who is predisposed to dementia, they often finger hypertension. There appears to be a link between midlife high blood pressure and dementia (Deckers et al, International Journal of Geriatric Psychiatry, March, 2015; Ashby-Mitchell et al, Alzheimer’s Research & Therapy, Feb. 17, 2017).

Is There a Link Between Blood Pressure and Dementia in Older People?

Any such connection in the elderly is more complicated, however. Some evidence links low rather than high blood pressure to cognitive decline.

A study published in JAMA Internal Medicine in 2015 reported on 172 elderly Italian patients attending memory clinics. People whose systolic blood pressure was below 128 appeared to have greater cognitive impairment.

More recently, a study published in the journal Alzheimer’s & Dementia tracked very old members of a California retirement community. Those who developed mild to moderate hypertension in their 80s were 42 percent less likely to experience dementia in their 90s.

Treat High Blood Pressure in the Very Elderly with Care:

Based on these new studies, doctors may want to exercise caution about how aggressively they treat hypertension in their oldest patients. The link between blood pressure and dementia may be more complicated than we previously imagined.

Mossello et al, JAMA Internal Medicine, April, 2015

Corrada et al, Alzheimer’s & Dementia, Feb. 2017

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  1. digitalrain

    Blood pressure can be graphed as an “s” curve. Too high or too low is bad. Could there be a link to cognitive decline be due to dying neurons by high BP damaging tiny blood vessels in the brain ? Or low blood pressure where oxygen and nutrients starve brain tissue.
    Perhaps this is why exercise is good for the brain. After all BP is not static all day ….unless you are sedentary. We have a tendency to focus on a symptom in isolation of other causative factors. Your choice is to take a pill or find and correct the causative factors.
    Find someone in your peer group with ideal BP and weight and eat what they do exercise as they do. I think intermittent fasting should be practised.

  2. Thai

    In an observation of “one”, my 94 year-old father, I can confirm this report! Dad had no high bp in mid life, but has been very overweight for years. In his 80s he developed mild high blood pressure, for which he takes a low dose bp med. He lives alone, drives, uses the computer daily, has an active social life, cooks lots of veggies, and eats a healthier diet than he did in earlier years (Mom passed at 86 of high bp-caused strokes). Mom was a wonderful 50’s/60’s cook, a homemaker who spoiled Dad with three scratch meals a day; delicious gravy, pies, second helpings. Great genes are of course a primary reason this tall Caucasian great grandpa with a large belly right out front made it to age 94 in good health. Those genes somehow prevented high bp in midlife, yet raised it in his elder years!

  3. Patti

    When the doctor had me on three high blood pressure meds, my daughters thought I had Alzheimers. I was about sixty- three at the time and had just discovered the high blood pressure. The drugs affected me considerably. I only take one at the present time and know even that affects my disposition.

  4. Larry

    Okay, so what should folks with lower blood pressure (e.g., 120/70) do to avoid dementia?

  5. Anne

    This is scary. I’m 65 in August, and I have very low blood pressure. On the other hand, my mother had very high blood pressure which was treated with medication. She had Alzheimer’s and at one point she had a fairly minor stroke. I almost hate reading these studies because there always seem to be variables.

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