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Does High Blood Pressure lead to a Small Brain?

Recent research published in the journal Hypertension suggests that people who develop high blood pressure before middle age have smaller brains and a higher risk of developing dementia. Researchers found that 35- to 44-year-old individuals who were diagnosed with high blood pressure were 61% more likely to develop some type of dementia within the next decade, compared to those in the same age group with normal blood pressure.

Brain volume size and dementia status were analyzed using the UK Biobank which is a large database of anonymous health information for half a million people living in the United Kingdom. In one analysis, they looked at brain volume measurements for 11,399 people with high blood pressure diagnosed before age 35; between 35 and 44; or between 45 and 54. They compared data for people in these groups to the same number of people in matching age groups who did not have high blood pressure. Those who had high blood pressure before 35 years of age showed the largest reduction in brain volume compared to those with normal blood pressure, even if their blood pressure later returned to normal.

In another analysis, the relationship between when people were diagnosed with high blood pressure and whether they developed any form of dementia up to 14 years later, was evaluated. Data for 124,053 people with high blood pressure was compared to the same number of people without high blood pressure. It was found that the earlier a person developed high blood pressure, the higher the risk for developing vascular dementia, a common form of dementia caused by poor blood flow to the brain. The risk was 69% higher for those diagnosed with high blood pressure between ages 35 and 44 and 45% higher for those diagnosed between ages 45 and 54.

This study provides evidence that an early age of onset of hypertension is associated with the occurrence of dementia and that this association is supported by structural changes in brain volume.

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