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High BP in Middle Age, Weaker Brain Later?

Study shows a link, but it's unclear if medications in midlife will ward off dementia
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WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

MONDAY, Aug 4, 2014 (HealthDay News) -- Let your blood pressure get too high in midlife, and you might pay the price in mental decline later on, a new study suggests.

The study of almost 14,000 people found that high blood pressure in those aged 48 to 67 was tied to a late-life drop in mental ability. Over 20 years, people with high blood pressure in midlife experienced a modest but significant 6.5 percent decline in scores on tests of mental function, compared with people with normal blood pressure.

"High blood pressure might be an important risk factor for dementia, since mental decline is a known risk factor," said lead researcher Dr. Rebecca Gottesman, an associate professor of neurology and epidemiology at Johns Hopkins University School of Medicine in Baltimore.

However, she stressed that because "we know how to treat high blood pressure," bringing it under control might also cut a person's risk for dementia.

For the study, Gottesman's team collected data on people taking part in a major U.S. heart disease study. The participants were followed for as long as 23 years and their mental abilities were tested three separate times.

Gottesman's group found that people whose blood pressure was controlled with medication had less mental decline than those with uncontrolled high blood pressure. The effect was stronger among whites than blacks, the researchers noted.

Blood pressure levels in middle age may be especially important to later-life mental acuity, Gottesman said.

"This may be why some clinical trials that have studied the role of blood pressure medications [in older people] have failed to find a benefit in reducing mental decline and dementia," she reasoned. "The trials may simply not be long enough -- it may be most important to start treatment of high blood pressure when people are middle-aged."

However, the jury is still out on whether blood pressure medication given in middle age can help boost late-life thinking and memory.

"In our study, people who were on medications to treat high blood pressure did have less mental decline than did people not on medications," Gottesman said. "But it's possible those people had been on medications for years."

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