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    Elevated BP May Prematurely Age the Brain

    Subtle Changes May Progress Over Time continued...

    But the changes they saw “are very consistent,” DeCarli says, and they look like the beginnings of the kind of damage that’s been seen in the brains of people with full-blown dementia and Alzheimer’s disease.

    In particular, the white matter, which is sometimes called the wiring of the brain because it carries nerve signals between brain areas, was starting to look frayed. While the grey matter, which makes up the bulk of the brain’s lobes, was starting to shrink.

    “This is quite disconcerting because high blood pressure is so common,” DeCarli says. “I worry this can be harmful over time and cause late-life cognitive disability if not aggressively treated.”

    Is There a Need for Aggressive Treatment of High BP in Younger Adults?

    This study doesn’t prove that high blood pressure alone caused the brain changes. Other studies have shown that diets high in saturated fat and sugar, the same eating patterns that are thought to contribute to obesity and high blood pressure, play a role in changes in the brain that are thought to lead to Alzheimer’s disease.

    But long before Alzheimer’s and dementia became commonly used terms, doctors said people with progressive memory loss had “hardening of the arteries,” which describes what happens when elevated blood pressure damages artery walls, making them stiff and less elastic.

    So far, studies looking at whether lowering high blood pressure with medications and lifestyle changes might help brain function have had mixed results. Treatment has mostly been tried in older adults, however, who may already have structural damage in the brain that is beyond repair.

    Experts think the most effective way to help the brain and other organs that are damaged by high blood pressure may be to catch and treat high BP as early as possible.

    “Dementia doesn’t start in old age. It starts way long before that,” says Merrill Elias, PhD, MPH, professor of neuropsychology and epidemiology at the University of Maine in Orono. Elias has spent his career studying the effects of blood pressure on the brain.

    “The message from this paper and all the papers that have preceded it on cognitive functioning is that you must control high blood pressure from the moment it emerges,” Elias says.

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