Fluctuating Blood Pressure Causes Brain Risks

fluctuating blood pressureOlder people who have more-than-average fluctuating blood pressure are at a higher risk of impaired cognitive function, according to recent research.[1] Dr. Simon Mooijaart of Leiden University Medical Centre in the Netherlands, and colleagues state that elements of the vascular system may contribute to the development and progression of dementia.1 Some of these cardiovascular risks may be reversible, but some may not.1

Mooijaart and colleagues investigated the link between variability in blood pressure and cognitive function in 5,461 people aged 70 to 82, who resided in Ireland, Scotland, and the Netherlands.1 All of the participants were taking part in a study of the impact of statin drugs on blood vessel health, as they were all at risk of cardiovascular disease.1 Their blood pressure was measured every three months, and a mental state examination was used to test cognitive function at the beginning of the study in order to exclude those with poor cognitive function.1 Then, after a follow-up of three years, participants were tested on four areas of cognitive function: attention, processing speed, immediate memory, and delayed memory.1

“Participants with higher visit-to-visit variability is systolic blood pressure had worse performance on all cognitive tests, independent of average blood pressure,” reported researchers.1

A subgroup of 553 participants underwent magnetic resonance imaging (MRI) of the brain.1 This was able to show that a greater variability in blood pressure was linked to a smaller hippocampus, a part of the brain vital for memory.1 There were also higher rates of cortical infarcts, or a type of stroke that causes difficulty with reading, writing, or speaking, as well as visual field defects.1

Researchers concluded, “Higher visit-to-visit variability in blood pressure, independent of average blood pressure and cardiovascular disease, was associated with impaired cognitive function in old age.”1

It has already been established that variability in blood pressure is linked to cerebrovascular damage—damage affecting the blood vessels to the brain.1 This raises the risk of stroke and microvascular damage, or changes in the small blood vessels of the cerebral cortex due to damage to the artery walls.1

“Our findings may suggest that decreased hippocampal volume, cerebral microbleeds, and cortical infarcts are potentially pathogenic mechanisms behind the association between variability in blood pressure and cognitive impairment,” researchers state.1

Future researcher should focus on determining whether reducing the variability in blood pressure can decrease the risk of cognitive impairment in old age.1

[1] Collingwood, J. (2014). Brain Risk from Fluctuating Blood Pressure. Psych Central. Retrieved on April 25, 2014, from http://psychcentral.com/news/2014/04/22/brain-risk-from-fluctuating-blood-pressure/68832.html

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