Drop blood pressure, drop dementia risk?

One more reason to control your blood pressure: reduce your risk of dementia. Maybe.

A recent Associated Press story says controlling blood pressure may be the best protection yet known against dementia. Scientists are saying that high blood pressure seems to create scarring in the brain as early as the middle ages, which leads to later development of Alzheimer's disease and other dementias.

"If you look ... for things that we can prevent that lead to cognitive decline in the elderly, hypertension is at the top of the list," Dr. Walter Koroshetz, deputy director of the National Institute of Neurological Disorders and Stroke, told The Associated Press. He said studies soon will get underway to see if people with hypertension can benefit from dropping blood pressure rates even lower than currently recommended.

Recent research has looked at MRI scans in women 65 and older, finding that those with worse blood pressure had higher volumes of "white matter damage," according to a study published in the Journal of Clinical Hypertension. Another study in the journal Stroke by researchers from Johns Hopkins University tracked 983 people starting in middle age for 15 years. It found that the longer people spent with uncontrolled high blood pressure, the more white matter damage they accumulated.

Certainly high blood pressure, alone, does not predict the development of dementia. But the National Institutes of Health plans to begin enrolling people this fall for a study called SPRINT, the Systolic Blood Pressure Intervention Trial. It's designed to look at heart and kidney health, but participants--7,500 people age 55 and older with hypertension--will also be screened for dementia. The question is whether taking agressive steps to lower systolic blood pressure below 120 will prove healthier than the current guidelines.

"We have a number of effective and safe medications to lower blood pressure," Dr. Lawrence Fine told HealthDay. He is chief of the clinical applications and prevention branch in the division of cardiovascular sciences at the National Heart, Lung, and Blood Institute. "For the average person right now, the recommendation is a blood pressure of 140/90 or lower. SPRINT will compare that with a goal of 120 as the top number. Will the rate of dementia for people in the lower-goal arm be lower than standard?"