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High Blood Pressure Damages Brain Structure among People as Young As 40

A recent study at UC Davis has found uncontrolled high blood pressure damages the brain’s structure and function as early as young middle-age.  Even the brains of middle-aged people who clinically would not be considered to have hypertension have evidence of silent structural brain damage.

The investigation found accelerated brain aging among hypertensive and pre-hypertensive individuals in their 40s, including damage to the structural integrity of the brain’s white matter and the volume of its gray matter, suggesting that vascular brain injury “develops gradually over the lifetime with discernible effects.”

The study is the first to demonstrate that there is structural damage to the brains of adults in young middle age as a result of high blood pressure, the authors said.  Structural damage to the brain’s white matter caused by high blood pressure previously has been associated with cognitive decline in older individuals.

Published online in the medical journal The Lancet Neurology, the study will appear in print in the December 2012 issue.  It emphasizes the need for lifelong attention to vascular risk factors for brain aging, said study senior author Charles DeCarli, professor of neurology and director of the UC Davis Alzheimer’s Disease Center.

“The message here is really clear: People can influence their late-life brain health by knowing and treating their blood pressure at a young age, when you wouldn’t necessarily be thinking about it,” DeCarli said.  “The people in our study were cognitively normal, so a lack of symptoms doesn’t mean anything.”

Normal blood pressure is considered a systolic blood pressure — the top number — below 120 and a diastolic pressure — the bottom number — below 80. Pre-hypertensive blood pressure range is a top number between 120 and 139 and a bottom number between 80 and 89. Blood pressures above 140 over 90 are considered high.

Elevated blood pressure affects approximately 50 million Americans and is associated with a 62 percent risk of cerebrovascular disease, such as ischemic stroke, and a 49 percent risk of cardiovascular disease. It is the single-greatest risk factor for mortality in the United States.

Earlier studies have identified associations between elevated blood pressure and a heightened risk of brain injury and atrophy leading to reduced cognitive performance and a greater likelihood of dementia, making hypertension an important, modifiable risk factor for late-life cognitive decline. There is evidence, the study says, that lowering blood pressure among people in middle age and in the young elderly can help prevent late-life cognitive decline and dementia.

“This work suggests that recently described white matter microstructural damage associated with high blood pressure in the elderly may be detectable earlier in the life span, further reinforcing the view that vascular brain injury may develop insidiously over several decades,” said Pauline Maillard, the study’s lead author and a postdoctoral fellow in the UC Davis Department of Neurology. “These results emphasize the need for early and optimum control of blood pressure, which is neither routinely achieved nor subject to testing in randomized controlled clinical trials.”

There are many ways you can get your blood under control without the use of medication:

1. Lose extra pounds and watch your waistline

Blood pressure often increases as weight increases. Losing just 10 pounds (4.5 kilograms) can help reduce your blood pressure. In general, the more weight you lose, the lower your blood pressure.

2. Exercise regularly

Regular physical activity — at least 30 to 60 minutes most days of the week — can lower your blood pressure by 4 to 9 millimeters of mercury (mm Hg). And it doesn’t take long to see a difference. If you haven’t been active, increasing your exercise level can lower your blood pressure within just a few weeks.

But avoid being a “weekend warrior.” Trying to squeeze all your exercise in on the weekends to make up for weekday inactivity isn’t a good strategy. Those sudden bursts of activity could actually be risky.

3. Eat a healthy diet

Eating a diet that is rich in fruits, vegetables and lean proteins and skimps on saturated fat and cholesterol can lower your blood pressure by up to 14 mm Hg. Many people struggle with changing their eating habits, which is why I always recommend keeping a food journal.  Writing down what you eat, even for just a week, can shed surprising light on your true eating habits. Monitor what you eat, how much, when and why.

4. Reduce sodium in your diet

Even a small reduction in the sodium in your diet can reduce blood pressure by 2 to 8 mm Hg. Try to limit sodium to 2,300 milligrams (mg) a day or less.  To decrease sodium in your diet, trying keeping a food journal, reading food labels, eating fewer processed foods like potato chips and frozen dinners, and lastly, just don’t add salt.  Use herbs or spices, rather than salt, to add more flavor to your foods.

5. Limit the amount of alcohol you drink

There’s more potential harm than benefit to drinking alcohol. If you drink more than moderate amounts of it, alcohol can actually raise blood pressure by several points and it can also reduce the effectiveness of high blood pressure medications.

6. Avoid tobacco products and secondhand smoke

On top of all the other dangers of smoking, the nicotine in tobacco products can raise your blood pressure by 10 mm Hg or more for up to an hour after you smoke.  Smoking throughout the day means your blood pressure may remain constantly high.

7. Cut back on caffeine

Drinking caffeinated beverages can temporarily cause a spike in your blood pressure.  Too much caffeine restricts blood flow to the brain, dehydrates the brain, body and skin, and fools the brain into thinking it does not need to sleep.

8. Reduce your stress

Stress or anxiety can temporarily increase blood pressure. Take some time to think about what causes you to feel stressed, such as work, family, finances or illness. Once you know what’s causing your stress, consider how you can eliminate or reduce stress. Try taking breaks for deep-breathing exercises. Get a massage or take up yoga or meditation.  If self-help doesn’t work, seek out a professional for counseling.

Source:  http://www.medicalnewstoday.com/releases/252269.php

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