A research paper published in JAMA Neurology suggests that elderly individuals with higher rates of fluctuation in their blood pressure may be more likely to develop dementia.
Kaiser Permanente Washington collaborated with researchers from Radboud University in the Netherlands to investigate if an individual's blood pressure changing frequently during middle age could be associated with a heightened risk of developing dementia in later life.
The study focused on 820 elderly persons aged between 65 and 90. At the beginning of the experiment and every two years afterwards, the individuals underwent a medical evaluation - including a mental examination.
The trial included elderly individuals living in the community who did not have cognitive impairments when the study began. All participants were aged 65 or above.
The information used in this study was collected from participants of the Adult Changes in Thought (ACT) study, a long-term survey of individuals.
The study showed that people in their 90s were at a higher risk of developing dementia if their blood pressure variability rate was high. Those aged 60, 70 or 80 were not affected by this rate.
They noted that high blood pressure remains a health risk factor for individuals aged 60 to 90.
The study revealed that fluctuations in blood pressure, as assessed through annual check-ups over three decades, were linked to the risk of dementia in individuals aged 90 or older. Notably, the connection between high systolic blood pressure and dementia varied between younger and older individuals, although it did not reach statistical significance.
Blood pressure naturally fluctuates throughout the day for most individuals, a common occurrence outlined by Harvard Health. These fluctuations can happen rapidly, even within minutes.
A 2020 report published in the Hypertension Journal identified potential factors contributing to blood pressure variability. These include factors such as ageing, gender (being female), body weight, smoking habits, alcohol consumption, psychological stress, how blood vessels respond to changes like cold exposure, and the presence of certain conditions affecting organs like the heart, kidneys, and blood vessels, including left ventricular hypertrophy, chronic kidney disease, peripheral vascular disease, and subclinical atherosclerotic disease.
A report published in 2018 in the Journal of Clinical Hypertension noted that blood pressure variability can be a short-term occurrence. These variations can be categorised into irregular patterns without a consistent trend and those with well-defined patterns over time. It's important to note that aside from dementia, these periodic blood pressure readings can also serve as indicators of cardiovascular risk.
In a recent study, hypertension was found to be associated with a higher risk of dementia in individuals in their 60s, 70s, and 80s. However, for people in their 90s, it was explicitly blood pressure variability that posed a more significant risk factor.
This research suggests that rather than high blood pressure alone, it is the variability in blood pressure that may increase the risk of dementia. Notably, this correlation was primarily observed in individuals aged 90 and above, highlighting the importance of maintaining stable blood pressure for the health of the heart and brain in later years.
The study's findings indicate that blood pressure variability may signify an elevated risk of dementia in late life. Still, it may not be as relevant as a target for preventing dementia during midlife.
During the study period, 372 participants developed dementia, with scientists relying on autopsy details and medical records from Kaiser Permanente Washington for their research.
Some experts noted limitations in the study. They suggested that there were limited instances of blood pressure measurement, advocating for more consistent data collection, which could impact medication choices. Factors such as other health conditions and lifestyle elements were not fully considered, which could influence the study outcomes.
However, the study's notable strengths include the availability of more than 30 years of continuous blood pressure data for the same individuals and regular cognitive assessments and dementia confirmation by a specialised committee.
It's worth noting that the study's limitations included the use of autopsy data from consenting participants in the ACT study, a predominantly white participant group with access to high-quality healthcare, and potential variations in the assessors' methods that might have affected blood pressure variability estimates.
In 2022, an article explored the treatment of blood pressure variability.
The study found that calcium channel blockers reduced variability while ACE inhibitors, beta-blockers, and alpha-blockers increased it.
The authors suggested that medical professionals should focus on controlling blood pressure without further research.
However, the article considered blood pressure variability concerning cardiovascular disease and the existing research is limited, with no consensus on the treatment approach.
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