Keeping Blood Pressure Under Control is Good for the Brain

Intensive management of hypertension (high blood pressure) significantly reduces the risk of adverse events in the brain such as stroke, according to a new study from The University of Texas Health Science Center at San Antonio (UT Health San Antonio). It also provides evidence of low blood pressure for brain health. Hypertension is a major risk factor for cardiovascular disease and stroke, with a 45.6% prevalence among US adults and an annual cost of $52 billion. Clinical trials studying the efficacy of antihypertensive drugs have demonstrated a decrease in the incidence of cardiovascular disease, stroke, myocardial infarction, and heart failure associated with these agents.

Small vessel disease and hypertension-related changes can also be associated with Alzheimers disease, non–Alzheimer's disease cognitive impairment, and advanced brain aging.

Hence, large-scale clinical trials with multimodal imaging are therefore essential to report robust findings on the precise improvement of brain regions with intensive hypertension treatment, which could explain brain reserve and cognition maintenance.

White Matter Lesion Volume Changes with Strict Blood Pressure Control

One such study published in JAMA Network Open compared intensive blood pressure control (target less than 120 mm Hg) versus standard control (target less than 140 mm Hg) in participants aged 50 or older with hypertension and without diabetes or a history of stroke.

Patients receiving intensive blood pressure treatment showed reduced white matter lesions in frontal and posterior deep white matter, and improved blood flow, indicating better overall brain health.

White matter lesions are among the changes that can be associated with Alzheimer’s disease, non–Alzheimer’s disease cognitive impairment, and advanced brain aging. Therefore, intensive blood pressure treatment can slow down vascular brain injury, potentially contributing to the preservation of cognitive function in older adults.

Specific areas have greater benefits, representing sensitive regions to track in future trials evaluating small-vessel disease. There is also a need for further research to determine the optimal blood pressure targets and treatment strategies for various population groups and to assess the potential side effects of intensive blood pressure treatment.

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Source-Eurekalert