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Does High Blood Pressure Increase Dementia Risk for Women?

Does High Blood Pressure Increase Dementia Risk for Women?

A new study suggests midlife hypertension may hurt your brain health later on.

As we make our way into midlife, many of us experience changes in our cardiovascular health. One of the most common conditions we may develop is hypertension, or high blood pressure, which is affected by diet and activity levels, among other factors. Approximately half of US adults have hypertension, and many either don’t have it under control, or aren’t aware they have it all.

And while hypertension is a risk factor for a range of health conditions, including cardiovascular disease and diabetes, new research has found that women who develop it before menopause may have a higher dementia risk, as well.

Connecting midlife hypertension to dementia in women
Although researchers have known for a while that hypertension is linked to dementia, a study published in Neurology in October 2017 has shed new light on one specific population. In this observational study, patients were followed from their mid-30s to their 70s and 80s. Researchers analyzed health records, including blood pressure measurements, of participants when they were in their 30s and 40s. They then followed up to see who developed dementia.

Researchers found that women—but not men—who had high blood pressure in their 40s were more likely to have dementia later in life. In fact, women who developed hypertension in midlife had a 73 percent higher risk of dementia compared to women whose blood pressure remained normal.

Untangling the study’s results
What might explain this selective increased risk of dementia in women but not in men?

“In general, women as a group tend to be relatively hormonally protected from vascular disease and specifically from hypertension," says Sam Aznaurov, MD, a cardiologist at Presbyterian/St Luke's Medical Center in Denver, Colorado. As a result, he adds, women often develop hypertension later in life than men.

That means women who have hypertension before menopause—when they’re supposed to be hormonally protected—may have more blood vessel damage. It’s theorized this could place them at increased risk for many health issues, including dementia, since those vessels supply the brain with oxygen.

What women should know
So, does that mean a woman in her mid-40s with hypertension will likely develop dementia? And is there anything women can do to protect themselves against this risk?

Since this study was observational, meaning health characteristics of a group were collected over time and later analyzed, it can’t be said for certain that hypertension causes dementia in this population. Some issues to consider, as well:

  • The study was relatively small. Although over 5,000 people were included at the beginning, a little more than half were included in the follow-up.
  • Research began in the 1960s, and hypertension treatment has advanced greatly since then. Therefore, the results may not be directly applicable to women who are in their 40s today.
  • Since more men died within the follow-up period, it is possible that they could have been diagnosed with dementia if they had lived longer; that means the results could have been skewed to show an effect for women but not men.

“If a woman in her 40s is reading this and saying, ‘Oh gosh, I have hypertension, that means I’m going to [get] dementia,’ that doesn’t necessarily mean that is going to be the case,” says Aznaurov. “The good news is that we have a wealth of data that shows that treatment of hypertension does reduce the risk of vascular disease.” In fact, this study suggested that women who treated their high blood pressure had no greater chances of developing dementia.

That treatment may include eating a well-balanced and low-sodium diet, limiting the use of alcohol, exercising regularly and maintaining a healthy weight. Remembering to take medications properly is also crucial, as is seeing your doctor to make sure you’re best managing your condition.

Ultimately, more research is needed to explore the link between hypertension and dementia in middle-aged women—but it doesn’t hurt to adopt a heart-healthy lifestyle in the meantime.

Medically reviewed in January 2020.

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