High blood pressure linked to changes in brain metabolism in mid-life

New research shows that keeping blood pressure under control throughout life could help protect brain health



A new study from the United States has shown that high blood pressure in mid-life (aged 46-54) is linked to changes in brain metabolism in regions of the brain that are linked with dementia. Early signs of plaques building up in the arteries and other risk factors for heart disease were also linked to the changes in brain metabolism. The results, published this February in the Journal of the American College of Cardiology, reinforce the need to keep high blood pressure and other risk factors under control from a young age to help prevent dementia in later life.  

Why was the study done?

The researchers aimed to find out whether the early stages of atherosclerosis and risk factors for heart disease affected brain metabolism in mid-life.

Atherosclerosis is where the blood vessels become furred up with fat, restricting blood flow around the body and leading to diseases of the heart and blood vessels (cardiovascular disease) including heart disease and stroke.

Advanced stages of atherosclerosis have been linked to a worsened brain function (cognitive impairment) in later life. Blood pressure control and good heart health have also been linked to a lower risk of dementia. However, the effect of early stages of atherosclerosis, high blood pressure and other risk factors for heart disease on brain health during mid-life has not been fully explored.

What did the study involve?

547 people who were taking part in the PESA (Progression of Early Subclinical Atherosclerosis) study were included in the research. They were aged 46-54, mostly male, with evidence of subclinical (early) atherosclerosis but with no symptoms. 

Participants were given a brain scan to look at their brain metabolism, ultrasound scans to look for signs of hardening in the arteries (atherosclerotic plaques), and assessment of risk factors for heart disease.

Risk of heart disease was measured using the 30-year Framingham Risk Score and includes high blood pressure. Risk factors include age, sex, systolic blood pressure (the top number), smoking, hypertension, diabetes, and high blood fats (cholesterol).

What did the study show?  

The brain scans showed that those with a higher risk of heart disease had reduced brain metabolism and this was mostly due to high blood pressure. Early stages of plaque formation in the arteries were also linked to reduced brain metabolism independently of heart disease risk. Importantly, the areas of the brain that were most affected were those involved in Alzheimer’s disease, a type of dementia.

The authors state that the results reinforce the need to control risk factors early in life, as this has the potential to reduce the brain’s vulnerability to cognitive impairment (dementia) in the future. 

They intend to continue their study to find out more about the links between atherosclerosis and brain health throughout life.

Nirmala Markandu, Hypertension Nurse Specialist at Blood Pressure UK commented:This study adds to what we have learned from previous research around blood pressure and brain health. High blood pressure affects younger people as well as the over 60s, and keeping your blood pressure under control throughout your whole life could help to protect your brain as well as your heart and kidneys." 

Read the study - Subclinical Atherosclerosis and Brain Metabolism in Middle-Aged Individuals: The PESA Study

Find out more about vascular dementia and high blood pressure

Find out how you can keep your blood pressure under control