Disclosures: The authors report no relevant financial disclosures.
October 04, 2021
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Early-onset hypertension associated with increased dementia risk

Disclosures: The authors report no relevant financial disclosures.
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When diagnosed in young adulthood or during midlife, hypertension was associated with smaller brain volumes and increased dementia risk, researchers reported in Hypertension.

The same was not true for hypertension diagnosed in late life.

Data were derived from Shang X, et al. Hypertension. 2021;doi:10.1161/HYPERTENSIONAHA.121.17608.

Xianwen Shang, PhD, MPH, research fellow at the Guangdong Provincial People’s Hospital, China, and colleagues evaluated data from participants from the UK Biobank collected from 2006 to 2010. Researchers performed two analyses including 11,399 participants with hypertension and 11,399 matched controls (mean age, 66 years; 42% women) for the brain volume analysis and 124,053 participants with hypertension and 124,053 matched controls (mean age, 60 years; 47% women) for the dementia analysis.

Researchers used brain MRI to measure brain volumes from 2014 to 2019 and dementia data were obtained through inpatient, mortality and self-reported data up to 2021.

In the multivariable analysis, smaller total brain volume was observed among individuals with a hypertension diagnosis at age younger than 35 years (beta = –10.83; 95% CI, –19.27 to –2.39), age 35 to 44 years (beta = –6.82; 95% CI, –12.18 to –1.46) and age 45 to 54 years (beta = –3.77; 95% CI, –6.91 to –0.64) compared with their respective controls. Hypertension was also independently associated with smaller gray matter volumes, peripheral cortical gray matter and white matter when diagnosed in early and midlife.

During a median follow-up of 11.9 years, there were 4,626 cases of incident all-cause dementia. After adjusting for covariates, only individuals with a hypertension diagnosis at age 35 to 44 years had an increased all-cause dementia risk compared with controls (HR = 1.61; 95% CI, 1.31-1.99).

In addition, a hypertension diagnosis during young adulthood or midlife was associated with smaller brain volumes and an increased dementia risk, but hypertension diagnosis during later life was not.

“Our study’s results provide evidence to suggest an early age at onset of hypertension is associated with the occurrence of dementia and, more importantly, this association is supported by structural changes in brain volume,” Shang said in a related press release. “Future research with brain volumes measured at multiple time points could confirm whether hypertension diagnosed at a younger age is associated with a greater decrease in brain volume over time.”