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Can high BP in middle age cause brain damage later?

By Apollo 24/7, Published on - 30 December 2020

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High blood pressure or hypertension is a common medical condition in which the long-term force of the blood flow is high enough to damage the cardiovascular system. The condition is a major culprit behind life-threatening health complications such as cardiovascular or heart disease, heart failure, and heart attack.
Nevertheless, high blood pressure can also affect other vital organs such as the brain. Over the years, a number of studies have investigated the effect of high blood pressure on brain health. A new study has stated that having high blood pressure in the 40s and 50s can lead to significant damage to brain tissue in later life. The study has made some noteworthy findings that all of us should know.

About the study

The study titled “Midlife blood pressure is associated with the severity of white matter hyperintensities: analysis of the UK Biobank cohort study” was published in the European Heart Journal on November 25, 2020. The research was led by Dr Karolina Wartolowska, a clinical research fellow at the Oxford University’s Centre for Prevention of Stroke and Dementia.
The study was conducted on 37,041 participants aged between 40 and 69 years. As part of the study, MRI brain scans of the participants were collected. The objective of the study was to look for "white matter hyperintensities" (WMH), a sign of damage in the brain. WMH are lesions that appear on the MRI brain scans as areas of increased brightness. They represent damage to the small blood vessels in the brain. The risk of WMH increases with age and blood pressure. People who have WMH are at an elevated risk of neurological and psychological problems like stroke, depression, dementia, and a decline in physical and cognitive abilities.
In order to compare the volume of WMH in participants and to address the problem of slight variation in their brain sizes, researchers divided the volume of white matter hyperintensities by the total volume of white matter in the brain. This way they could analyze the WMH load - the proportion of the volume of white matter hyperintensities to the total volume of the white matter.

Findings of the study

  • The study found that diastolic blood pressure in people in their 40s and 50s is linked to extensive brain damage in later life. It noted that a higher WMH load was strongly linked to current systolic blood pressure. However, the strongest correlation was with past diastolic blood pressure, particularly in middle-aged people. Researchers say this means that managing diastolic blood pressure is also important to prevent damage to brain tissue.
  • Among the top 10% of participants with the highest WMH load, having systolic blood pressure over 120mmHg accounted for 24% of the load. On the other hand, 7% of the load was attributed to diastolic blood pressure above 70mmHg.
  • The study showed that even a relatively low surge in blood pressure beyond the normal range correlated with a higher amount of WMH. This implies that increased blood pressure starts damaging the brain tissue even before it meets the treatment criteria for hypertension.
  • The proportion of WMH load increased by an average of 1.126-fold for every 10mmHg increase in systolic blood pressure beyond the normal range. On the other hand, for every 5mmHg increase in diastolic blood pressure above the normal range, the proportion of WMH load rose by an average of 1.106-fold.
The findings of the study suggest that control of diastolic blood pressure may be required in early midlife while control of systolic blood pressure may be more important in late life. However, in order to prevent damage to the brain in later life, it is important to focus on the management of blood pressure as early as possible.

How to manage blood pressure?

Lifestyle and diet play an essential role in the management of blood pressure. According to health experts, making healthy changes to these important aspects can help lower blood pressure to a great extent. Some of the most effective lifestyle and dietary changes that can help lower blood pressure include:
  • Lose weight
  • Increase physical activity and exercise more
  • Follow a balanced and healthy diet
  • Reduce the intake of salt
  • Limit consumption of alcohol
  • Quit tobacco
  • Limit intake of caffeinated beverages
  • Manage stress
  • Monitor blood pressure regularly

Conclusion

High blood pressure is a circulatory disease that can affect the functioning of all the vital organs. The brain is one such vital organ that is at the risk of sustaining damage from high blood pressure. The new study has only provided more evidence to prove this fact. Experts believe the study is a reminder for everyone to focus more on healthy eating, exercise, and other ways to manage blood pressure.
Talk to a cardiologist if you have any questions related to heart health.

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