Aggressive Blood Pressure Treatment Cuts Death and Reduce Dementia Risk: Study

Lowering blood pressure lowers the risk of serious heart problems and even cuts the risk of death for adults aged 50 and above, according to a 2015 study.

The study of more than 9,300 patients aged 50+ with hypertension showed that lower blood pressure significantly reduced the chance of major cardiovascular disease events like heart disease, stroke, heart failure, and death.

The research said using a combination of medicines to reduce systolic pressure to a target of 120 versus 140 cut the rate of heart attacks, strokes, and heart failure by almost a third and the risk of death by nearly a quarter.

"This study provides potentially life-saving information that will be useful to health care providers as they consider the best treatment options for some of their patients, particularly those over the age of 50."

Dr. Gary Gibbons, director of the National Heart, Lung, and Blood Institute (NHLBI)

Lower Blood Pressure Benefits Health

Systolic blood pressure, the arterial pressure when the heart contracts, is the top number in a blood pressure reading. High blood pressure is widely considered a leading risk factor for heart disease, kidney failure, and other health problems. Many of these health issues can cause death or increase the risk of the need for long-term health care in older adults.

The vast majority of blood pressure medicines from a variety of classes are available as inexpensive generics. The classes include angiotensin receptor blockers, ARBs, such as Novartis' Diovan, calcium channel blockers, like Pfizer's Norvasc, ACE inhibitors, and Pfizer's Altace diuretics, such as Merck's Hyzaar.

Doctors on a conference call to discuss the study said blood pressure of 120 over 80 was shown to be desirable, but that 140/90 was a commonly used target. They also noted that there is no real consensus, which was a reason for conducting the trial.

"Patients should talk to their doctor to determine whether this lower goal is best for their individual care."

Dr. Lawrence Fine, chief of Clinical Applications and Prevention at the NHLBI.

According to the Cleveland Clinic, one in three Americans over the age of 18 years suffers from hypertension. They indicate the prevalence is higher among older individuals, women, and non-Hispanic blacks. 

Despite the increase in prevalence, recent data from the National Health and Nutrition Examination Survey (NHANES) demonstrate an improvement in blood pressure control (50%) among Americans with hypertension. However, the blood pressure control rate remains suboptimal in people with serious comorbid conditions such as chronic kidney disease.

High Blood Pressure and Dementia Connection

Control of blood pressure has many positive impacts on health. The Alzheimer's Association says several conditions known to increase the risk of cardiovascular diseases — such as high blood pressure, diabetes, and high cholesterol — also increase the risk of developing Alzheimer's. Some autopsy studies show that as many as 80 percent of individuals with Alzheimer's disease also have cardiovascular disease.

In 2020 research, published in the journal Hypertension, confirmed a connection between high blood pressure and cognitive decline. High blood pressure was shown to speed up memory loss in middle-aged adults and the elderly. 

The study showed those who were not taking medication to lower high blood pressure saw faster declines in cognitive ability than those without high blood pressure or whose blood pressure was under control with medication. 

While there has always been a concern about uncontrolled high blood pressure and the risk of heart attack and stroke, the connection with cognitive decline has a tremendous impact on aging and long-term health care.

With longer lifespans and bigger demand for long-term care, the pressure on society is even greater. While you cannot prevent aging and declining health, simple steps to control hypertension better could reduce some of the risks of dementia.