Blood pressure treatment and its surprising role in dementia prevention

A recent study from UNSW Sydney’s Centre for Healthy Brain Ageing (CHeBA) has revealed a promising discovery for individuals aged 60 and above who are undergoing treatment for high blood pressure, finding that they may experience a significant 26 per cent reduction in their risk of developing dementia compared to their untreated counterparts.

The study drew from extensive data collected in 15 countries, including Australia, the USA, Brazil, China, Italy, the Central African Republic, and Nigeria, involving a massive group of 34,519 participants.

The global challenge of dementia is growing rapidly, with about 57 million people currently living with the condition, and projections suggest this number could skyrocket to 153 million by 2050. Hypertension stands out as the most widespread risk factor for dementia, impacting over 1 billion people worldwide.

Lead author of the study, Dr Matt Lennon, highlighted the importance of these findings for general practitioners and family physicians, given they often find themselves on the front lines of managing blood pressure-related concerns, making these discoveries particularly pertinent to their clinical practice.

“We know that mid-life hypertension increases risk of all types of dementia by around 60%, and Alzheimer’s disease by 25%,” Lennon said.

“However, in late-life (i.e. those older than 60) studies have variously found high blood pressure to increase, not affect or decrease dementia risk. This lack of clarity is deeply problematic.”

New research from CHeBA reveals treating high blood pressure in those over 60 can cut #dementia risk by 26%. ???? The study in @JAMA_current analysed data from 34,519 people across 15 countries. With dementia on the rise, managing hypertension is crucial.

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— UNSW Centre for Healthy Brain Ageing (CHeBA) (@CHeBA_UNSW) September 14, 2023

The study found that older individuals with untreated high blood pressure are at a significantly higher risk of dementia compared to those on medication or those with healthy blood pressure. Importantly, this risk reduction through treatment applies to people in their 70s and 80s too.

Additionally, the research showed that a single blood pressure check in later life doesn’t give us much information about dementia risk. Instead, it’s better to track blood pressure over time for treatment decisions.

Lastly, the study revealed that the impact of blood pressure and medication is similar across different genders and racial groups, emphasising the importance of managing high blood pressure for everyone.

“This is a very promising result as it suggests that optimal care for one group will be similar for others,” Lennon said.

“No study previously has been able to assess the differential effects of blood pressure and antihypertensives in developing nations.

“Our study included three major studies of ageing based in Nigeria and the Central African Republic. It is critical that an understanding of chronic illness management in the developing world is published and disseminated. It is precisely in these areas where chronic illnesses are least well understood but also where the majority of new dementia cases will occur in the coming decades.”