Brain May Benefit by Lowering Blood Pressure

Treatment May Stop or Slow a Type of Brain Abnormality, Study Shows

From the WebMD Archives

Sept. 7, 2005 -- Getting blood pressure under control is good for the brain, new research shows.

Health experts already knew that curbing blood pressure can help avoid strokes, heart attacks, and other serious health problems.

Now, French doctors report that lowering blood pressure may halt or slow the progression of brain abnormalities called white matter hyperintensities (WMH). Their study appears in Circulation.

WMH and High Blood Pressure

WMH are white areas in the brain. They're strongly linked to high blood pressure. WMH may be accompanied by dementia, depression, and trouble with walking.

"People with high blood pressure are more likely to develop WMH, and a larger volume of WMH are associated with cognitive decline, an increased risk of dementia, and accelerated brain aging in some hypertensive patients," says Christophe Tzourio, MD, PhD, in an American Heart Association news release.

Tzourio works in Paris at INSERM, France's national institute for health and medical research. With colleagues, he studied WMH and blood pressure treatment.

Brain and Blood Pressure Study

The study included 192 people. Participants were about 60 years old, on average. Most were men. All had had a stroke or "mini-stroke" (transient ischemic attack, or TIA) in the past five years.

At the study's start, about half of the group had high blood pressure. MRI brain scans showed that 42% had no WMH, 13% had moderate WMH, and 19% had severe WMH.

About a third of the group got medicine to treat their high blood pressure. They either got an ACE inhibitor and a diuretic (water pills) or just the ACE inhibitor. The rest of the patients got a fake drug (placebo).

Study's Findings

About three years later, more brain scans were done. The results:

  • 24 people had developed new WMH.
  • People taking blood pressure medicines were 43% less likely to have new WMH than those taking the placebo.
  • New WMH were smaller in patients taking the blood pressure medicines.

The results didn't change after factoring in age, sex, stroke type, blood pressure at the study's start, or WMH severity when the study began.

As expected, blood pressure dropped more with the prescription medicines than with the placebos.

Check Your Blood Pressure

The researchers call for more studies to find the best blood pressure treatments to curb WMH.

Meanwhile, there are plenty of reasons to get high blood pressure under control. "Uncontrolled high blood pressure can lead to stroke, heart attack, heart failure, or kidney failure," states the web site of the American Heart Association (AHA).

Nearly one in three U.S. adults has high blood pressure, but almost a third of them don't know it, according to the AHA.

The first step: Get your blood pressure checked. Then, you and your doctor can see if lifestyle changes (like quitting smoking, upgrading your diet, or being more active) and medication could help.

The study was sponsored in part by Servier, a French pharmaceutical company.

Show Sources

SOURCES: Dufouil, C. Circulation, Sept. 13, 2005; vol 112: pp 1644-1650. News release, American Heart Association. American Heart Association: "High Blood Pressure."
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