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Lowering High Blood Pressure Can Reverse Some Dementia in the Elderly

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WebMD Health News

May 18, 2001 (San Francisco) -- Three years ago Charles Vincent was overweight and had high blood pressure and high cholesterol. Worse, he was having trouble with his memory, having one too many "Alzheimer's moments."

 

Today, his blood pressure is a healthy 130/75, he is 20 pounds lighter, and his cholesterol is fine, even by the new stricter standards issued this week. Most of all, "I may not be as sharp as I was when I was 20, but I can do math faster than most 20-year-olds."

 

And just two days ago Vincent celebrated his 83rd birthday.

 

The difference between 1999 and this year can be explained by his blood pressure, says Edwin Jacobson, MD. Jacobson says that about 40% of dementia symptoms are caused not by Alzheimer's disease but by high blood pressure, a condition called vascular dementia.

 

Jacobson, a clinical professor of medicine at UCLA school of medicine, says that in a study of 66 patients with high blood pressure as well as mild dementia symptoms, controlling blood pressure meant that "progression of dementia was stopped and some effects of cognitive impairment were reversed." He presented his findings here this week at the 16th Scientific Meeting of the American Society of Hypertension.

 

Vincent, a retired business executive, tells WebMD that just a year ago his blood pressure was 160/90, not considered dangerously high "but high enough to affect my memory and ability to think clearly."

 

Jacobson says that a magnetic resonance scan of Vincent's brain confirmed that Vincent's brain had many small white scars, the type of damage that is associated with tiny, silent strokes. These silent strokes are "markers for vascular dementia," says Jacobson.

 

Jacobson says that many researchers have described the link between high blood pressure and dementia, but no one has attempted to reverse the dementia by controlling blood pressure.

 

In his study, 24 women and 42 men, aged 65 to 80, with high blood pressure and vascular dementia (as confirmed by magnetic resonance scans), were randomly chosen to take one of two different types of blood pressure medications. One drug, Vasotec, is what's called an ACE inhibitor, and the other drug, Plendil, is what's known as a calcium channel blocker. AstraZeneca, maker of Plendil, funded the study.

 

In addition to magnetic resonance scans, the patients were also assessed using memory and psychological tests. At study onset the scores on those tests were about "20% to 40% below normal. That means that these were people who were functioning but they were becoming limited. For example, they didn't wander off, but you wouldn't want these patients driving," says Jacobson.

 

Jacobson says that drug doses were increased until the patient reached the blood pressure goal of 130/90. Using this aggressive treatment approach "patients reached the goal by 12 weeks," says Jacobson. All patients had repeat memory and psychological tests at 12 weeks and again at six months.

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