Midlife Hypertension Associated with Later-life Mental Decline

A study spanning 20 years found people with hypertension in middle age (48 to 67 years old) are more likely to experience cognitive decline in their 70s and 80s.

Rebecca Gottesman, MD, PhD, and colleagues at Johns Hopkins University School of Medicine said the results, published online August 4, 2014, in JAMA Neurology, strengthen an association already seen in earlier research. The study followed 13,476 African American and white participants in the Atherosclerosis Risk in Communities cohort (1990-1992 through 2011-2013) in multiple states.

Midlife hypertension and elevated midlife (but not late-life) systolic blood pressure (BP) was associated with a greater cognitive decline during the 20 years patients were followed. Whites with a higher midlife BP showed a larger decline than African Americans. Furthermore, people with hypertension at the start of the study were twice as likely to have died by 2011 than those without it.

Patients with hypertension who took medication to treat it had an intermediate level of mental decline, similar to those in the prehypertension group. According to the study results, those who had hypertension during midlife had a 6.25% steeper decline than those with normal BP readings.

“It may not seem like a huge effect, but that’s just the average amount of cognitive decline,” Gottesman explains. “Some people probably have a significantly larger amount of decline. Since the number of people with hypertension is huge on a population scale, that leads to a lot of people with hypertension-related dementia.”