How hypertension’s links to dementia make blood pressure control even more important
Links between dementia and hypertension are reasons to keep blood pressure under tighter control – sooner rather than later
The patient initially came to see Dr Mark Supiano in 2017 because her family was concerned about her short-term memory loss.
While taking her history and vital signs, Supiano, a geriatrician at the University of Utah, in the United States, saw that her blood pressure was 148/86: above normal despite her taking two medications intended to lower it. “Clearly that was too high,” he says.
Several factors could have contributed to the high reading, including the anti-inflammatory drug the 78-year-old woman took for arthritis pain, her high-sodium diet and lack of regular exercise. She also told Supiano that she typically drank a couple of glasses of wine each evening.
After Supiano discussed ways to reduce her risk, the woman and her husband joined a gym. She stopped taking the anti-inflammatory drug and cut back on salt and alcohol, bringing her systolic blood pressure readings into the 130-to-140 range – still
hypertensive, according to the guidelines issued by the American Heart Association (AHA) and the American College of Cardiology (ACC) later that year, but more acceptable.
Systolic pressure – the measurement of pressure when the heart beats and contracts – is the top number in the blood pressure ratio and the more clinically important number. The second number – diastolic – measures pressure between heartbeats.
By 2019, though, the patient had a diagnosis of mild cognitive impairment, and medical evidence was emerging about a connection between hypertension – high blood pressure – and dementia.