High Blood Pressure in Midlife Can Negatively Impact Cognition Years Later

Having high blood pressure in your 50’s may impact your ability to keep track or plan ahead in your 80’s.

This study reports a connection between high blood pressure at a younger age can affect cognition many years later. It currently appears in the Journal of Alzheimer’s Disease.

Life expectancy is on the rise and people the age of 80 are the fastest growing demographic in the world. Several studies have demonstrated that high cardiovascular risk at midlife, particularly hypertension, is linked to subsequent increased risk of dementia. However, there is a lack of studies that examine the impact of midlife cardiovascular risk on early cognitive impairment in individuals in their later decades.

Using data from the Framingham Heart Study (FHS), Boston University School of Medicine researchers measured blood pressure from 378 FHS participants when they were between 50-60 years old, and then tested their cognitive performance approximately 30 years later when they were 80 years or older. Participants with high blood pressure at midlife scored more poorly on tests of attention and executive function later in life.

“Decline in cognition is often considered an inevitable consequence of aging, and age is the single biggest risk factor for dementia, but perhaps managing factors that impact brain aging, such as blood pressure, will help increase brain health and reduce the risk for dementia,” explained corresponding author Rhoda Au, PhD, professor of neurology at BUSM.

This image shows a person checking their blood pressure.
According to the researchers, if your blood pressure is not within normal range when you are younger, you should speak to your doctor and develop a plan to reduce it to normal levels and sustain it, which might include exercise, weight loss and medication. Image is for illustrative purposes only.

According to the researchers, if your blood pressure is not within normal range when you are younger, you should speak to your doctor and develop a plan to reduce it to normal levels and sustain it, which might include exercise, weight loss and medication.

“Midlife health matters. The pathway to one’s older years is through the younger years and taking care of your health while you are younger may help you better preserve your cognitive health when you are older,” added Au.

About this neurology research

The design, conduct, collection and management of the data was supported by the Framingham Heart Study’s National Heart,

Funding: Lung, and Blood Institute contract (N01-HC-25195) and by grants from the National Institute of Neurological Disorders and Stroke (R01 NS17950) and from the National Institute on Aging (R01AG16495;AG08122; AG029451).

Source: Gina DiGravio – Boston University Medical Center
Image Credit: The image is in the public domain
Original Research: Abstract for “Midlife Hypertension Risk and Cognition in the Non-Demented Oldest Old: Framingham Heart Study” by Nishtala, Arvind, Himali, Jayandra J., Beiser, Alexa, Murabito, Joanne M., Seshadri, Sudha, Wolf, Philip A., and Au, Rhoda in Journal of Alzheimer’s Disease. Published online July 16 2015 doi:10.3233/JAD-141881


Abstract

Midlife Hypertension Risk and Cognition in the Non-Demented Oldest Old: Framingham Heart Study

Abstract Midlife cardiovascular risk, hypertension (HTN) in particular, has been related cross-sectionally to poorer neuropsychological (NP) performance in middle age and older adults. This study investigated whether a similar relationship persists between midlife HTN or systolic blood pressure (SBP) and NP performance approximately 30 years later. 378 Framingham stroke and dementia-free Original cohort participants, with HTN and SBP ascertained between 50–60 years of age (mean age 55 ± 1, 65% women), were administered a NP assessment at age ≥80 years. Tests included Logical Memory, Visual Reproduction, Paired Associate, Hooper Visual Organization Test, Trail Making A & B, Digit Span Forward and Backward, Controlled Word Association Test (COWAT), and Similarities. Multivariable linear regression, adjusted for age, time interval between risk factor and NP testing, gender, and premorbid intelligence, assessed association between midlife HTN/SBP and NP outcomes. Midlife HTN was not significantly associated with NP outcome measures. Midlife SBP was associated with poorer Digit Span Forward and COWAT performance (p  <  0.05). No significant interaction of age on HTN/SBP to NP associations was found. There was a significant interaction between ApoE4 status and SBP in their effects on COWAT (pinteraction  = 0.074); SBP was negatively associated with COWAT only in those with the ApoE4 allele (p  = 0.025). While midlife HTN is not associated with late life cognitive impairment, midlife SBP is related to late life attention and verbal fluency impairments, particularly among ApoE4+ individuals. These results offer insight into processes that are operative in the absence of overt cognitive impairment and dementia. "Midlife Hypertension Risk and Cognition in the Non-Demented Oldest Old: Framingham Heart Study" by Nishtala, Arvind, Himali, Jayandra J., Beiser, Alexa, Murabito, Joanne M., Seshadri, Sudha, Wolf, Philip A., and Au, Rhoda in Journal of Alzheimer’s Disease. Published online July 16 2015 doi:10.3233/JAD-141881

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