Ask the Expert - High Blood Pressure and Dementia | Alzheimer's Prevention Registry

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March 11, 2016

Ask the Expert - High Blood Pressure and Dementia

By Alzheimer's Prevention Bulletin

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Our March expert is Charles DeCarli, MD, Professor of Neurology and Director of the Alzheimer’s Disease Center at the University of California, Davis.

Dear Dr. DeCarli,
High blood pressure runs in my family. My brother and I are in our 40s and we’re both watching our blood pressure creep up. At my last physical, my doctor said I was pre-hypertensive. My brother says high blood pressure can contribute to dementia. Is it true? What can my brother and I do to manage our blood pressure?


Dear Terry,

Your questions are timely – for both you and your brother – and important to your long-term health. I applaud both of you for looking into this while still in your forties. Most don’t, but should.

First, your brother is correct that pre-hypertension and hypertension (high blood pressure) may lead to cognitive decline and dementia. There’s overwhelming evidence that controlling blood pressure is critically important to brain health. We’ve recently learned that pre-hypertension and high blood pressure start to affect the brain structure when people are still relatively young, like you and your brother. It basically ages the brain. A 40-year-old with pre-hypertension (between 120-139 systolic or between 80-89 diastolic) or high blood pressure (anything at or over 140/90) may have the characteristics of a brain that’s years older.

What symptoms occur to alert you early-on that your high blood pressure is increasing your risk for cognitive impairment or dementia? Unfortunately, there are no symptoms. With high blood pressure, the brain’s blood vessels are silently deteriorating, affecting blood flow and your ability to think and learn. What’s truly alarming is that once your blood vessels are changed, you can’t do anything about it.

Terry, you said your physician told you’re pre-hypertensive. If you don’t make important lifestyle changes, your blood pressure will likely continue to increase.  
I advise people to get aggressive about treating your high blood pressure through medication – if your doctor recommends it – as well as exercise and diet. And, of course, by not smoking. Your primary care physician can help you devise a plan that may or may not include medication. You’ll also need to commit long-term to lifestyle changes such as:

  •  Maintaining a healthy weight
  •  Embracing regular physical activity 
  •  Consuming a healthy diet
  •  Reducing salt intake
  •  Limiting alcohol consumption 

Because you’re interested and motivated to deal with your pre-hypertension, I recommend you visit Mind Your Risks to learn more about uncontrolled blood pressure and cognitive health.  

Best of health to you and your brother!