Blood pressure link to brain damage

There may be a link between high blood pressure and increased brain damage among the elderly.
There may be a link between high blood pressure and increased brain damage among the elderly.

Higher than normal blood pressure in midlife may be linked to more extensive brain damage in the elderly.

A new study indicates there is a strong association between diastolic blood pressure (the blood pressure between heartbeats) before the age of 50 and brain damage in later life.

This also applies if the diastolic blood pressure is within what is normally considered to be a healthy range.

The findings come from a study of 37,041 participants enrolled in UK Biobank, a large group of people recruited from the general population aged between 40 and 69.

Oxfoed University's Dr Karolina Wartolowska looked for damage in the brain called white matter hyperintensities.

WMH show up on MRI brain scans as brighter regions and indicate damage to the brain's small blood vessels. This damage increases with age and blood pressure.

They are associated with an increased risk of stroke, dementia, physical disabilities, depression and a decline in thinking abilities.

"Not all people develop these changes as they age but they are present in more than 50 per cent of patients over the age of 65 and most people over 80 even without high blood pressure," Dr Wartolowska said.

"But it is more likely to develop with higher blood pressure and more likely to become severe."

Systolic blood pressure is the maximum blood pressure reached each time the heart beats and is the top number in blood pressure measurements.

The study, published in the European Heart Journal, found a higher load of WMH was strongly associated with current systolic blood pressure.

The strongest association was for past diastolic blood pressure, particularly when under the age of 50, researchers found.

For every 10mmHg (millimetres of mercury) increase in systolic blood pressure above the normal range, the proportion of WMH load increased by an average of 1.126-fold, and by 1.106-fold for every five mmHg increase in diastolic blood pressure.

Among the top 10 per cent of people with the greatest WMH load, 24 per cent of the load could be attributed to having a systolic blood pressure above 120mmHg.

"We made two important findings," Dr Wartolowska said.

"Firstly, the study showed diastolic blood pressure in people in their 40s and 50s is associated with more extensive brain damage years later.

"This means it is not just the systolic blood pressure, the first, higher number, but the diastolic blood pressure, the second, lower number, that is important to prevent brain tissue damage.

"The second important finding is that any increase in blood pressure beyond the normal range is associated with a higher amount of white matter hyperintensities.

"This suggests that even slightly elevated blood pressure before it meets the criteria for treating hypertension has a damaging effect on brain tissue."

Australian Associated Press