In the Journals

Mildly elevated systolic BP confers dementia risk in middle-aged adults

In adults aged 50 years, systolic BP of at least 130 mm Hg was associated with elevated risk for dementia, according to findings published in the European Heart Journal.

Systolic BP of 130 mm Hg to 139 mm Hg is considered hypertension under the 2017 American College of Cardiology/American Heart Association hypertension guideline, but is not considered hypertension by most other guidelines.

“Our analysis suggests that the importance of midlife hypertension on brain health is due to the duration of exposure. So, we see an increased risk for people with raised blood pressure at age 50, but not 60 or 70, because those with hypertension at age 50 are likely to be ‘exposed’ to this risk for longer,” Archana Singh-Manoux, PhD, research professor at the French National Institute of Health and Medical Research (INSERM) in Paris and honorary professor at University College London, said in a press release.

Jessica G. Abell, MD, postdoctoral research fellow at INSERM and a research associate in dementia and epidemiology at University College London, and colleagues analyzed 8,639 participants (33% women) from the Whitehall II cohort study who had BP measured in 1985, 1991, 1997 and 2003. Participants with dementia (n = 385) were identified by electronic health records through 2017.

After adjustment for sociodemographic factors, health behaviors and time-varying chronic conditions, systolic BP of at least 130 mm Hg at age 50 years was associated with increased risk for dementia (HR = 1.38; 95% CI, 1.17-1.7).

The relationship was not evident at age 60 or 70 years, and diastolic BP was not associated with dementia at any age, Abell and colleagues wrote.

Those with longer exposure to systolic BP of at least 130 mm Hg from age 45 to 61 years had elevated risk for dementia than those with low or no exposure to systolic BP of at least 130 mm Hg at those ages (HR = 1.29; 95% CI, 1-1.66), according to the researchers.

Among those free from CVD during the follow-up period, systolic BP of at least 130 mm Hg at age 50 years remained associated with increased risk for dementia (HR = 1.47; 95% CI, 1.15-1.87), Abell and colleagues wrote.

“It is important to emphasize that this is observational, population-level research and so these findings do not translate directly into implications for individual patients,” Abell said in the release. “Furthermore, there is considerable discussion on the optimal threshold for the diagnosis of hypertension. There is plenty of evidence to suggest that maintaining a healthy blood pressure in middle age is important for both your heart and your brain later in life. Anyone who is concerned about their blood pressure levels should consult their GP.” – by Erik Swain

Disclosures: The authors report no relevant financial disclosures.

In adults aged 50 years, systolic BP of at least 130 mm Hg was associated with elevated risk for dementia, according to findings published in the European Heart Journal.

Systolic BP of 130 mm Hg to 139 mm Hg is considered hypertension under the 2017 American College of Cardiology/American Heart Association hypertension guideline, but is not considered hypertension by most other guidelines.

“Our analysis suggests that the importance of midlife hypertension on brain health is due to the duration of exposure. So, we see an increased risk for people with raised blood pressure at age 50, but not 60 or 70, because those with hypertension at age 50 are likely to be ‘exposed’ to this risk for longer,” Archana Singh-Manoux, PhD, research professor at the French National Institute of Health and Medical Research (INSERM) in Paris and honorary professor at University College London, said in a press release.

Jessica G. Abell, MD, postdoctoral research fellow at INSERM and a research associate in dementia and epidemiology at University College London, and colleagues analyzed 8,639 participants (33% women) from the Whitehall II cohort study who had BP measured in 1985, 1991, 1997 and 2003. Participants with dementia (n = 385) were identified by electronic health records through 2017.

After adjustment for sociodemographic factors, health behaviors and time-varying chronic conditions, systolic BP of at least 130 mm Hg at age 50 years was associated with increased risk for dementia (HR = 1.38; 95% CI, 1.17-1.7).

The relationship was not evident at age 60 or 70 years, and diastolic BP was not associated with dementia at any age, Abell and colleagues wrote.

Those with longer exposure to systolic BP of at least 130 mm Hg from age 45 to 61 years had elevated risk for dementia than those with low or no exposure to systolic BP of at least 130 mm Hg at those ages (HR = 1.29; 95% CI, 1-1.66), according to the researchers.

Among those free from CVD during the follow-up period, systolic BP of at least 130 mm Hg at age 50 years remained associated with increased risk for dementia (HR = 1.47; 95% CI, 1.15-1.87), Abell and colleagues wrote.

“It is important to emphasize that this is observational, population-level research and so these findings do not translate directly into implications for individual patients,” Abell said in the release. “Furthermore, there is considerable discussion on the optimal threshold for the diagnosis of hypertension. There is plenty of evidence to suggest that maintaining a healthy blood pressure in middle age is important for both your heart and your brain later in life. Anyone who is concerned about their blood pressure levels should consult their GP.” – by Erik Swain

Disclosures: The authors report no relevant financial disclosures.