Keep your Blood Pressure Well Controlled

What do we know?

It’s been known for a long time that there is an association between a person’s blood pressure and their risk of developing Dementia.

This seems particularly true for high blood pressure in middle age (40-65 years old) with conflicting evidence about the risks of high blood pressure in older patients.[i] It is thought that the high pressure damages the small blood vessels in the brain making the blood vessels also allow beta-amyloid (according to www.ScienceDirect.com beta-amyloid is a protein fragment that is deposited on the brain in the form of sticky, starch-like plaques that are significantly more prevalent in People with Alzheimer's disease (AD) than in healthy older adults) to leak and cause Alzheimer's Disease.

Nurse taking the blood pressure of a male patient

Get your blood pressure checked and keep it well controlled.

[i] Hypertension and the Risk of Dementia. C Sierra. Frontiers in Cardiovascular Medicine. Jan 2020

What’s New

A new study has been published in Nature Medicine with authors from the US and China.[i] They found that the group who had intensive blood pressure control (including lifestyle changes, such as weight loss and reducing salt intake) and on average three types of blood pressure tablets (ACE inhibitor, diuretic or calcium channel blocker) reduced their blood pressure to below 130/80 on average. The other half just had left intensive blood pressure control and blood pressure dropped to about 145/80.

The group with more intensive treatment had 16% fewer people with cognitive decline and 15 % fewer people with a diagnosis of Dementia. This was a very powerful prospective (looking forward) blinded study, so the findings are very important.

This aligns with a study from John Hopkins which looked to see which type of blood pressure treatment was most helpful in reducing Dementia risk. [ii] They found that people who took any blood pressure treatment lowered their risk of Dementia by about a third and using potassium-sparing diuretics (eg spironolactone, triamterene and amiloride) reduced the risk of Dementia by nearly 75%.

[i] Blood Pressure reduction and All-Cause Dementia  in people with uncontrolled hypertension, J He et al. Nature Medicine. Feb 2025.

[ii] Use of diuretics is associated with reduced risk of Alzheimer’d Disease. Y Chuamg et al. Journal of Neurobiol Aging. May 2014.

What should we do?

High blood pressure is very common in the UK and is often underdiagnosed and undertreated. 

Left untreated it can lead to strokes, heart and kidney disease and we’ve known that treating the blood pressure lowers these risks. Now we also know that treating blood pressure lowers the risk of Dementia.

So get you blood pressure checked as part of the NHS Check Up or at your pharmacy. Life Style changes are important and its worth making sure your blood pressure is fully controlled!

Dr Mark Spencer

Dr Spencer is an experienced Regional Medical Director with a demonstrated history of working in the hospital & health care industry. Skilled in Family Medicine, Service Change and Innovation. he was the Clinical Lead to the largest transformational change programme in the NHS. Dr Spencer has worked many years as a GP having studied Medicine at Charing Cross Medical School. Although he is not a Dementia Expert, his wife, who passed away, had a rare form of Dementia associated with Multiple Sclerosis.

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