Hypertension, which is a condition that affects almost half of U.S. adults can increase your risk of stroke and heart disease. Research has also shown that high blood pressure can lead to dementia later in life. These people can be prevented from developing dementia by taking certain medications. Researchers didn’t yet know which medications could prevent dementia.
Researchers published a large-scale meta analysis in June 2021 in Hypertension. It found that hypertension medication that travels out of blood vessels to the brain (known as crossing the blood-brain border) caused cognitive decline in people more than blood pressure medications that remain in the bloodstream.
We know that lowering blood pressure can be beneficial for cognitive decline and dementia risk, but there are many different drugs. The question was: do these drugs have a variety of mechanisms to benefit cognitive decay or just lowering blood pressure?” said Daniel Nation, PhD, the study’s co-author and an associate professor of psychology and faculty member of UCI MIND’s Institute for Memory Impairments and Neurological Disorders.
Dr. Nation and his associates compared research on drugs that cross the blood-brain barrier and affect the renin angiotensin system. This hormone system is related to blood pressure, and plays a part in memory and learning. The data was analyzed on two types of drugs: angiotensin II receptor blocking (ARBs) and angiotensin-converting gene (ACE) inhibitors. These drugs are often used to treat hypertension.
The analysis covered nearly 13,000 individuals over 50 from 14 studies in six countries.
“This was not an examination of any one drug or class of drugs. It was a property of the drug, whether it gets in the brain. It wouldn’t take a drastic change in physicians’ prescribing practices if they were convinced that this property was valuable. Nation stated in a press release that they could choose another drug from the same family that crosses this blood-brain barrier.
A fluke in the results and areas for future research
Researchers were puzzled by the surprising result that patients who did not take drugs that crossed the blood-brain barrier had better attention outcomes than those who took drugs which crossed to the brain. While cardiovascular disease can affect attention, it’s not considered a sign that you have dementia. Nation and Jean Ho (PhD), a postdoctoral scholar at UCI MIND are currently pursuing new research to better understand those results.
This research may help to open the door for other prescribing methods that consider hypertension.
Constantino Iadecola (PhD), director of the Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, said that “Alzheimers was built as a brain disease in which nothing else has any connection with it.” He wasn’t involved in the study. High blood pressure is the main cause of brain damage. It is also a significant contributor to Alzheimer’s. The message to the community: If you treat high blood pressure you can also treat Alzheimer’s disease.
Iadecola recommends that patients regularly check their blood pressure to ensure they are treated promptly. Iadecola advises Black patients with hypertension, especially those who are prone to it, to get treatment as soon as possible.