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Many people with high blood pressure know that they could be at risk for stroke and heart attack. However, too many people, despite what they may know, still are not motivated by these facts to get their high blood pressure under control. Now a new risk of high blood pressure is emerging: the possible connection between uncontrolled blood pressure and dementia. Important new studies link high blood pressure, especially in midlife, to an increased risk for dementia later in life.
Scientists are working hard to learn more about this connection. In the meantime, don’t take unnecessary risks. Keep your blood pressure under control.
“People need to think about how they can decrease their chances of developing dementia in later life. With what we now know, controlling hypertension is at the top of the list.”
Walter Koroshetz, M.D., Director of NIH's National Institute of Neurological Disorders and StrokeWhat role does your blood pressure play in keeping your brain healthy?
Let’s work together to connect the dots. Test your knowledge of brain health by taking this interactive quiz.
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This research may someday lead to new treatments to prevent or slow the most serious forms of dementia. In the meantime, though, evidence suggests that vascular dementia — one of the most common dementia diagnoses — may be preventable. Vascular dementia usually occurs due to the cumulative impact of multiple strokes, including small “silent” strokes that occur unnoticed as we age. High blood pressure is the main culprit. Over time, high blood pressure weakens the arteries, leads to strokes, and may bring on processes in your body that can cause dementia. There are many ways that you can improve your chances of healthy brain aging — from taking blood pressure control medicines prescribed by your doctor to lifestyle changes such as exercise, weight loss, and quitting smoking.
Most of us know someone — a friend, a family member — living with dementia. Many people think of it as a single disease with the main symptom being memory loss. However, a number of different diseases can result in dementia, and the word itself describes a group of symptoms that negatively affect how the brain works. Symptoms include memory loss, as well as changes in mental abilities such as reasoning and judgment, in a way that can make it difficult to perform any number of once routine daily activities. Some people with dementia can experience changes in personality while others may become agitated, delusional, or have slowed thinking. Memory loss alone does not mean someone has dementia.
Alzheimer’s disease is the most common form of dementia. There are drugs that may improve the quality of life for people who have it, but there is no cure for the disease.
Vascular dementia is caused by “silent strokes,” also called infarcts (tissue damage), that can often go unnoticed. Damage to the brain, as a result of multiple strokes over time, gradually leads to a loss of brain function.
Moreover, population-based autopsy studies have shown that many patients who die with dementia often have a combination of both Alzheimer’s pathology and brain injury due to vascular disease or silent strokes, often called “mixed dementia.” Experts now believe that the processes that give rise to vascular disease in the brain and Alzheimer’s disease may converge, dramatically increasing the likelihood and severity of dementia more than either condition alone.
Strokes can cause a host of cognitive disabilities, including effects on memory, speech and language, and everyday problem solving. But even without suffering an obvious stroke, individuals at risk for stroke may experience cognitive impairment as their blood vessels deteriorate. Silent strokes and vascular damage to the “wires” that connect brain regions cause diffuse white matter disease. These brain changes increase one’s risk of later developing age-related cognitive decline and dementia.
Learn more about dementia at our NINDS Dementia Information Page. There, you can also find out about other organizations that provide helpful information.
Learn more about some of the research on high blood pressure, dementia, and stroke.
Stroke occurs when blood circulation to the brain fails either because blood flow is blocked or because a blood vessel ruptures and bleeds into surrounding brain tissue. Brain cells can die as a result and the consequences can be mild to severe depending on the size and location of the stroke.
Transient ischemic attack (TIA), sometimes called a mini-stroke, starts just like a stroke but then resolves leaving no noticeable symptoms or deficits. The occurrence of a TIA is a warning that the person is at risk for a more serious and debilitating stroke.
Silent strokes (or infarcts) show up as multiple areas of ischemic tissue damage (which occurs when an artery to the brain is blocked) on MRI scans or in brains examined after death. In contrast to strokes that cause immediate and obvious consequences, silent strokes go unnoticed because they are so small, or because they occur in areas that are not directly responsible for movement, speech, vision, or other critical functions.
Diffuse white matter disease is a change in brain structure that can be seen on MRI scans in the majority of older people, affecting as many as 80 percent of those over age 80. Research has demonstrated an association between these white matter lesions and blood pressure levels, with higher blood pressure over time being linked to more extensive areas of white matter damage. Some studies also suggest a link between severe white matter lesions and diminished performance on tests of cognitive function.
Heart disease is a disorder of the blood vessels of the heart that can lead to a heart attack. A heart attack happens when an artery becomes blocked, preventing oxygen and nutrients from getting to the heart.
“People need to think about how they can decrease their chances of developing dementia in later life. With what we now know, controlling hypertension is at the top of the list.”
Walter Koroshetz, M.D., Director of NIH's National Institute of Neurological Disorders and StrokeWhat role does your blood pressure play in keeping your brain healthy?
Let’s work together to connect the dots. Test your knowledge of brain health by taking this interactive quiz.
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Following a healthy eating plan and keeping physically active on a regular basis will significantly lower your risk for heart disease, high blood pressure, type 2 diabetes, and other chronic and debilitating health problems.
Smoking harms nearly every organ in the body, including the heart. Any amount of smoking, even light or occasional smoking, damages the heart and blood vessels.
Reducing your cholesterol will lower your risk for developing a wide variety of serious health issues, including stroke and heart disease.
Know your blood pressure! If left unchecked, high blood pressure can damage the cells of your arteries' inner lining and cause a hardening called arteriosclerosis, blocking blood flow to your heart, brain, and kidneys, as well as to your muscles.
Having diabetes or pre-diabetes puts you at increased risk for stroke and heart disease. You can lower your risk by keeping your blood glucose (also called blood sugar), blood pressure, and blood cholesterol close to the recommended target numbers provided by your doctor.
Generally, an increase in alcohol consumption leads to an increase in blood pressure. The use of illicit drugs, such as cocaine and methamphetamines, can cause stroke.
This is the hard part, but keeping your heart and brain as healthy as you can will lead to better overall health as you age.
Your doctor may recommend taking aspirin or other drugs daily to prevent stroke and heart attack, especially if you have hypertension.
Preventing stroke and heart disease is more effective if started in midlife. Studies also find that controlling blood pressure may also reduce risk of dementia.
Mind Your Risks® is a public health campaign that educates people with high blood pressure about the importance of controlling blood pressure in midlife (from the ages of 45 to 65) to help reduce the risk of having a stroke and possibly developing dementia later in life.
Mind Your Risks® is a campaign from the National Institute of Neurological Disorders and Stroke (NINDS), one of the institutes at the National Institutes of Health (NIH).
Mind Your Risks® is a public health campaign that educates people with high blood pressure about the importance of controlling blood pressure in midlife (from the ages of 45 to 65) to help reduce the risk of having a stroke and possibly developing dementia later in life.
Mind Your Risks® is a campaign from the National Institute of Neurological Disorders and Stroke (NINDS), one of the institutes at the National Institutes of Health (NIH).
Many health and government organizations offer tools and resources to help you with blood pressure control.
Centers for Disease Control and Prevention provides fact sheets on stroke, and heart disease; podcasts on heart healthy diets, downloadable PDFs on high blood pressure in English and Spanish, sodium intake, and information from the Million Hearts® community of health workers.
Million Hearts® Team Up. Pressure Down. (PDF, 332 KB) has animated videos on treatment, handouts, a medication tracker wallet card, and much more.
Million Hearts® for Clinicians Microsite offers evidence-based protocols, action guides, quality improvement tools, and patient resources to help clinicians and other health professionals reduce their patients’ risk for a heart attack or stroke.
National Heart, Lung, and Blood Institute offers patient information in English and Spanish and specific resources including a Google hangout video on “Myth busting blood pressure.”
The National Institute of Neurological Disorders and Stroke offers information on stroke treatment and management on its Know Stroke website, as well as information on a variety of neurological disorders.
The National Institute on Aging offers information on Alzheimer’s disease and other forms of dementia on its Alzheimer’s Disease Education and Referral (ADEAR) website.
MedlinePlus offers basic information about high blood pressure, including an animated slide show on its causes, complications, diagnoses, and control.
The YMCA’s Blood Pressure Self-Monitoring program helps adults with hypertension lower and manage their blood pressure. The program supports participants in properly using a self-monitoring blood pressure cuff, and provides nutrition education and personalized support emphasizing the value of regular self-monitoring. The YMCA’s Blood Pressure Self-Monitoring program is growing and is available in a number of communities across the United States.
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Check out the current scientific research.
“About one in three Americans — around 70 million people — have high blood pressure, and only half of them have their blood pressure under control.”
Gary Gibbons, M.D., Director of NIH’s National Heart, Lung, and Blood InstituteAs part of the Mind Your Risks® campaign, NINDS has developed several strategic partnerships with national organizations.
Million Hearts® is a national initiative with an ambitious goal to prevent 1 million heart attacks and strokes by 2017. The Centers for Disease Control (CDC) and Prevention and the Centers for Medicare & Medicaid Services co-lead the initiative on behalf of the U.S. Department of Health and Human Services (HHS).
Sponsored by the HHS’s Administration for Community Living (ACL), the “What is Brain Health?” public health education program aims to help millions of older adults take steps to optimize brain health as they age.
National Institute on Aging (NIA), one of the 27 institutes and centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. NIA is the primary Federal agency supporting and conducting Alzheimer's disease research.
The Heart Truth is a national campaign for women about heart disease and is sponsored by the National Heart, Lung, and Blood Institute (NHLBI). Through the campaign, the NHLBI leads the nation in a landmark heart health movement embraced by millions who share the common goal of better heart health for all women.