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Are hypertension and blood pressure changes in early adulthood associated with late-life brain health? According to a new study from UC Davis, the answer is yes, especially for men.
Many younger adults may pay little attention to issues like blood pressure, but it’s a good opportunity for journalists to remind their audience that heart health matters at every age.
In a cohort study published in JAMA Open on April 3, researchers looked at 427 adults 50 years and older and found high or increasing blood pressure in early adulthood were associated with lower mean regional brain volumes and changes in the structure of white matter later in life. These associations were stronger in men than women for some regions of the brain.
Using data from the Study of Healthy Aging in African Americans (STAR) and Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study, which included racially and ethnically diverse adults 50 and older from the San Francisco Bay area and Sacramento Valley in California, researchers analyzed health assessments conducted between June 1, 1964, and March 31, 1985. Regional brain volumes and white matter (WM) integrity were measured via magnetic resonance imaging between June 1, 2017, and March 1, 2022. White matter is the brain’s nerve fibers, which connect different areas of the brain to each other and to the spinal cord. Damage to this area can create issues with memory, balance and walking, according to the Cleveland Clinic.
Hypertension status (normal, transitional or high) was assessed during early and mid adulthood (average age 28.9 and 40.3). Researchers then looked at MRI results when participants were an average of 74.8. A total of 263 participants (61.6%) were female and 231 (54.1%) were Black.
Compared with participants who had normal blood pressure, those who had hypertension and those who transitioned to hypertension had smaller brain, frontal cortex (associated with thinking, organizing and planning), and parietal cortex volumes (sensory integration and self perception). Participants with hypertension also had smaller hippocampal volume, (associated with short-term memory) greater ventricular volumes, and other negative changes in brain volume. These factors are associated with dementia.
Additionally, researchers found that brain changes in some regions were stronger in men, which may be related to protective benefits of estrogen prior to menopause, according to the study’s authors.
This study is further evidence that managing health indicators in early and middle adulthood matters. The authors noted, “these efforts are especially important for racial and ethnic minority groups, such as older Asian, Black, and Latino adults in the U.S., among whom older Black and Latino adults experience a disproportionate risk of dementia. Older Black adults have an excess risk of hypertension, and all 3 groups (older Asian, Black, and Latino adults) have a low prevalence of hypertension control compared with their White counterparts.”
Hypertension is a common but easily treatable condition affecting nearly half (47%) of U.S. adults, according to the CDC. It’s defined as a systolic blood pressure greater than 130 mmHg or a diastolic blood pressure greater than 80 mmHg. (Normal blood pressure is 120/80). High blood pressure increases risk of stroke and heart disease, and costs the U.S. health system about $131 billion annually. Only about one-fourth of adults have their high blood pressure under control.