Midlife Hypertension Linked to Increased Risk for Dementia

high blood pressure dementia

Story at-a-glance -

  • Elevated blood pressure may raise your dementia risk at levels below those officially labeled as “high”
  • In a study of more than 8,600 adults, having a systolic blood pressure of 130 or greater at age 50 was associated with a 38 percent increased risk of dementia, which suggests that prehypertension at midlife could be putting you at risk of dementia in later life
  • High blood pressure can lead to damage in your blood vessels, including small blood vessels in your brain that play a role in thinking and memory; it may increase dementia risk by hampering the way blood, and thereby oxygen and nutrients, is delivered to your brain
  • Research suggests tractography, a 3D modeling technique, could be used to detect early signs of hypertension-induced brain damage long before symptoms of dementia occur, allowing for therapeutic interventions

By Dr. Mercola

About 75 million Americans, or 1 in 3 adults, have high blood pressure,1 a condition that increases your risk of heart disease, stroke and, as research increasingly shows, dementia. Elevated blood pressure may even raise your dementia risk at levels below those officially labeled as "high." In a study of more than 8,600 adults, having a systolic blood pressure of 130 or greater at age 50 was associated with a 38 percent increased risk of dementia.2

Systolic blood pressure (the first number in a blood pressure reading), represents the pressure in your blood vessels when your heart beats. High blood pressure is generally defined as 140/90 mmHg or higher, while a reading of 120/80 mmHg to 139/89 mmHg is considered at risk, or prehypertension.3 The study suggests that prehypertension, which also affects 1 in 3 adults, at midlife could be putting you at risk of dementia in later life.

How Does Elevated Blood Pressure Raise Your Dementia Risk?

High blood pressure can lead to damage in your blood vessels, including small blood vessels in your brain that play a role in thinking and memory.4 By hampering the way blood is delivered to your brain, high blood pressure could have devastating effects on your brain health. According to Keith Fargo, director of scientific programs and outreach for the Alzheimer's Association, in HealthDay News:5

"The brain is a very metabolically active organ in the body. It requires an outsized amount of oxygen and other nutrients … Because of that, there's a very, very rich blood delivery system in the brain. Anything that happens to compromise that is going to compromise the overall health and function of the brain."

Vascular dementia, the second most common type of dementia after Alzheimer's, is particularly associated with high blood pressure. It results when blood flow to the brain is reduced, starving brain cells of oxygen and nutrients necessary for optimal function.6 The Alzheimer's Society also highlighted several additional ways that high blood pressure may alter your brain function:

  • Strain to your arteries, leading to arteriosclerosis, in which the arteries become stiffer and narrower; this hampers the delivery of nutrients and oxygen, which can damage brain cells
  • High blood pressure is the strongest risk factor for stroke, which can cause brain cell death that leads to stroke-related or post-stroke vascular dementia
  • Narrowed blood vessels can lead to small bleeds (microbleeds) or blockages in the small deep blood vessels in your brain, which can lead to small vessel disease over time; this, in turn, contributes to the development of subcortical vascular dementia

While hypertension in middle age has long been linked to dementia, it's becoming clear that hypertension at an earlier age may also increase the risk. Among women in their 40s with high blood pressure, dementia risk could be increased by as much as 73 percent, although the same association did not hold true for men.7

Subtle Brain Damage Caused by High Blood Pressure Could Be Detected Early

While the signs and symptoms of dementia often don't show up until late in life, the changes leading up to it may start much earlier. "Your dementia risk is really a lifelong thing. People think about dementia in late life, because that's when it's common to see the clinical symptoms. But everything that is setting you up for cognitive decline is occurring throughout your life," Fargo added.8

Usually, the damage caused by chronic high blood pressure to the brain is revealed via conventional magnetic resonance imaging (MRI), but by the time the brain damage is visible, it may be too late to stop the neurodegeneration. Research published in Cardiovascular Research suggests, however, that tractography, a 3D modeling technique, could be used to detect early signs of hypertension-induced brain damage, long before symptoms of dementia occur.9

Giuseppe Lembo, the study's coordinator, said in a news release, "The problem is that neurological alterations related to hypertension are usually diagnosed only when the cognitive deficit becomes evident, or when traditional magnetic resonance shows clear signs of brain damage. In both cases, it is often too late to stop the pathological process."10

For the study, patients with no sign of brain damage via conventional neuroimaging, and no diagnosis of dementia, received a specialized MRI scan to identify microstructural damage in the brain's white matter.

Among patients with hypertension, deterioration of white matter fibers connecting brain areas associated with attention, emotions and memory were found. This diagnostic technique could identify hypertension-induced damage earlier, allowing for the damage to be addressed before any other signs or symptoms emerge. Study author Lorenzo Carnevale noted:11

"An important aspect to consider is that all the patients studied did not show clinical signs of dementia and, in conventional neuroimaging, they showed no signs of cerebral damage. Of course, further studies will be necessary, but we think that the use of tractography will lead to the early identification of people at risk of dementia, allowing timely therapeutic interventions."

If Your Blood Pressure Is Elevated, Dietary Changes — And Fasting — Are Important

In order to effectively treat and recover from high blood pressure, it's important to understand its underlying cause, which is often related to your body producing too much insulin and leptin in response to a high-carbohydrate and processed food diet. As your insulin and leptin levels rise, it causes your blood pressure to increase. Eventually, you may become insulin and/or leptin resistant.

A ketogenic, low net-carb, high-fat diet is far healthier and will allow your body to burn fat rather than glucose as its primary fuel. This has the sought-after side effect of improving mitochondrial function, which is foundational for disease prevention and optimal health. When your mitochondria are damaged or dysfunctional, not only will your energy reserves decrease, resulting in fatigue and brain fog, but you also become vulnerable to degenerative diseases including neurodegenerative decay.

Fasting is a natural partner to a ketogenic diet and is one of the most effective ways to normalize your insulin/leptin sensitivity. I recommend limiting your eating to two meals per day, either breakfast/lunch or lunch/dinner, within a six- to eight-hour window each day. This meal timing is a form of intermittent fasting, as by eating all your meals within a certain span of time each day, you end up fasting daily as well. Longer water fasts also offer powerful health benefits, although you need to work your way up to them.

Beets Help Lower Your Blood Pressure

One superfood to add to your diet if you're struggling to control your blood pressure is beets. Beets have powerful benefits for both your blood pressure and your brain, especially when combined with exercise, courtesy of their high nitrate content. Your body transforms nitrates into nitric oxide (NO), which enhances oxygenation and has a beneficial impact on your circulatory and immune systems.

In one study, 26 middle-aged men and women diagnosed with high blood pressure were given either beet juice or a placebo to drink three times a week, an hour before exercise, for six weeks.12 The beet juice increased tissue oxygenation and blood flow in the treatment group. It also improved brain neuroplasticity by improving oxygenation of the somatomotor cortex, a brain area that is often affected in the early stages of dementia.

Keep in mind, however, that beets are high in sugar, and their high sugar content can make raw beets and beet juice counterproductive during the initial transitioning phase of a ketogenic diet, as you're trying to get your body to burn fat instead of sugar as its primary fuel. In these instances, fermented beet juice, also known as beet kvass, may be a far preferable option, as virtually all of the sugar is eliminated during the fermentation process.

I often include about 1 to 2 ounces of raw beets in my daily smoothie, in addition to taking a fermented beet root powder supplement. However, if you have diabetes or are insulin resistant, carefully monitor how raw beet juice affects your overall health. Dark leafy greens are another good source of naturally occurring nitrates that are converted into NO in your body.

Leafy greens actually contain even more nitrates per serving than beets, with arugula taking the No. 1 spot among vegetables, followed by rhubarb. Eating garlic may also help, as although it's low in nitrates, it helps boost NO production by increasing nitric oxide synthase (NOS), which converts L-arginine to NO in the presence of cofactors such as vitamins B2 and B3.13

Do the Nitric Oxide Release Workout

NO is a soluble gas stored in the lining of your blood vessels, called the endothelium. NO is produced inside your endothelial cells from the amino acid L-arginine, where it acts as an important signaling molecule throughout your body. Along with promoting healthy endothelial function and heart health, NO supports healthy blood flow by helping your veins and arteries dilate. This, in turn, allows vital oxygen and nutrients to flow freely throughout your body — beneficial for your circulation and brain health.

On average, you lose 10 percent of your body's ability to make nitric oxide for every decade of life, but calisthenic exercises can help increase NO production. There are many that can be used, but I typically do a modified version of one developed by Dr. Zach Bush.

The Nitric Oxide Dump involves just four movements — squats, alternating arm raises, non-jumping jacks and shoulder presses — which are done in repetitions of 10, with four sets each. The workout takes just three or four minutes and should be repeated three times a day, with a minimum of two hours between sessions.

Physical fitness is important not only for lowering your blood pressure but also for decreasing dementia risk. In fact, researchers from the University of Gothenburg in Sweden revealed that women with the highest cardiovascular fitness had an 88 percent lower risk of dementia than those with moderate fitness.14

Further, even maintaining average fitness is worthwhile, as women with the lowest fitness had a 41 percent greater risk of dementia than those of average fitness. Cardiovascular fitness can be a measure of how well blood is circulating to your heart and brain.

Study author and physiotherapist Helena Horder told Time, "If the small blood vessels and circulation in the heart are OK, then the brain is also affected in a positive way by good small vessel circulation."15 Your regular workouts should also incorporate strength training, which has also been shown to have a strong impact on brain function and memory.16

EFT to Address the Emotional Side of Hypertension

Hypertension often has an emotional component to it, especially if you're chronically stressed or anxious. In addition to the lifestyle changes mentioned, stress management should be a regular part of your hypertension-reduction plan, and using the Emotional Freedom Techniques (EFT) is one excellent suggestion. EFT involves a combination of tapping specific energy meridians on your body while voicing positive affirmations.

This works to clear the "short-circuit" — the emotional block — from your body's bioenergy system, thus restoring your mind and body's balance, which is essential for optimal health and the healing of physical disease. In the video above, you can follow along with Julie Schiffman as she guides you through an EFT session to help you recover from hypertension.

It's a good idea to try this out even if your blood pressure is only mildly (or occasionally) elevated, as the sooner you take steps to get your blood pressure under control, the less impact it will have on your overall health, including that of your brain, in the future.