Mid-life Hypertension Results in Cognitive Decline Over a 20-Year Period

Researchers at the Johns Hopkins University School of Medicine have linked high levels of blood pressure during mid-life to increased risk of dementia over a 20-year period.

Study author Rebecca F Gottesman examined the impact of mid-life hypertension (48-67 years) on cognitive decline and risk of dementia. The researchers evaluated data, of 13,476 participants, from the Atherosclerosis Risk in Communities (ARIC). 

Out of the total, 3,229 were of African-American origin. The maximum follow-up period was 23.5 years.

The decline in global cognitive score for those who suffered from hypertension was 6.5 times higher than those with normal blood pressure.

An average ARIC participant with normal blood pressure at baseline had a drop of 0.840 global cognitive score points during the 20-year follow-up period as compared to those with pre-hypertension with score 0.880 and those with hypertension with score 0.896.

It was noticed that people with high blood pressure using medication had less cognitive decline during the follow-up period as compared to patients with untreated hypertension.

Further, the greater drop in global cognition scores was linked with an increase in mid-life blood pressure in white participants as compared to the African Americans.

"Although we note a relatively modest additional [cognitive] decline associated with hypertension, lower cognitive performance increases the risk for future dementia, and a shift in the distribution of cognitive scores, even to this degree, is enough to increase the public health burden of hypertension and pre-hypertension significantly. Initiating treatment in late life might be too late to prevent this important shift. Epidemiological data, including our own study, support midlife BP [blood pressure] as a more important predictor of - and possibly target for prevention of - late-life cognitive function than is later-life BP," the researchers wrote in the study.