World first study discovers link between high blood pressure and dementia

Researchers have made a groundbreaking discovery by pinpointing specific regions of the brain that sustain damage from high blood pressure, which could contribute to a decline in cognitive processes and the development of dementia.

The study, published in the European Heart Journal has shed light on how high blood pressure leads to such issues by utilising a combination of brain magnetic resonance imaging (MRI), genetic analyses, and observational data from numerous patients.

Co-author of the study, Professor Joanna Wardlaw, Head of Neuroimaging Sciences at the University of Edinburgh, said that “it has been known for a long time that high blood pressure is a risk factor for cognitive decline, but how high blood pressure damages the brain was not clear.”

“This study shows that specific brain regions are at particularly high risk of blood pressure damage, which may help to identify people at risk of cognitive decline in the earliest stages, and potentially to target therapies more effectively in future.”

As part of the study, researchers utilised brain MRI imaging, along with a technique known as Mendelian randomisation, to determine whether high blood pressure was the actual cause of changes to specific brain regions or simply associated with these changes.

Researchers found that nine distinct brain regions, including the putamen, which regulates movement and learning, as well as the anterior thalamic radiation, anterior corona radiata, and anterior limb of the internal capsule, which are all involved in decision-making, emotional management, and executive function, were impacted by high blood pressure, leading to decreases in brain volume and surface area, alterations in brain connections, and changes in measures of brain activity.

Genetic analyses identify brain structures related to cognitive impairment associated with elevated blood pressure https://t.co/1hVIG9NZ0P@escardio #EHJ #ESCYoung #cardiotwitter @ehj_ed @rladeiraslopes pic.twitter.com/dVGTWIQOKn

— European Society of Cardiology Journals (@ESC_Journals) March 28, 2023

Tomasz Guzik, Professor of Cardiovascular Medicine, at the University of Edinburgh (UK) and Jagiellonian University Medical College, who led the research, said “we hope that our findings may help us to develop new ways to treat cognitive impairment in people with high blood pressure.”

“By using this combination of imaging, genetic and observational approaches, we have identified specific parts of the brain that are affected by increases in blood pressure, including areas called the putamen and specific white matter regions,” Guzik explained.

“We thought these areas might be where high blood pressure affects cognitive function, such as memory loss, thinking skills and dementia. When we checked our findings by studying a group of patients in Italy who had high blood pressure, we found that the parts of the brain we had identified were indeed affected.

“Studying the genes and proteins in these brain structures could help us understand how high blood pressure affects the brain and causes cognitive problems.

“Moreover, by looking at these specific regions of the brain, we may be able to predict who will develop memory loss and dementia faster in the context of high blood pressure. This could help with precision medicine, so that we can target more intensive therapies to prevent the development of cognitive impairment in patients most at risk.”

Latest figures from the Australian Institute of Health and Welfare estimated that there were 401,300 Australians living with dementia in 2022.

According to predictions, Australians impacted by dementia is expected to exceed 849,300 people by 2058, more than twice the current number.