High blood pressure in your 30s is associated with worse brain health in your 70s

summary: High blood pressure in the thirties increases the risk of dementia and cognitive decline later in life. Treating high blood pressure early can help prevent dementia and Alzheimer’s disease in people in their 70s.

sauce: University of California, Davis

High blood pressure in your 30s is linked to worsening brain health around age 75, especially in men, according to a new study from the University of California, Davis.

Research published this week JAMA network opencompared magnetic resonance imaging (MRI) brain scans in hypertensive and normotensive older adults between the ages of 30 and 40 years.

Researchers found that regional brain volume was significantly reduced and white matter integrity was compromised in the hypertensive group. Both factors are associated with dementia.

The study also showed that negative changes in the brain in some areas were stronger in men, such as decreased amounts of gray matter and frontal cortex. They note that the differences may be related to the protective effects of estrogen before menopause.

“Dementia treatment is so limited that identifying modifiable risk and protective factors throughout life is key to reducing the disease burden,” said lead author, Department of Public Health Sciences. said Kristen M. George, assistant professor at

“High blood pressure is an incredibly common and treatable risk factor associated with dementia. This study shows that hypertensive conditions in early adulthood are important for brain health decades later.” I have,” said George.

High blood pressure epidemic in the United States

High blood pressure, also called hypertension, is blood pressure that is higher than normal. Normal blood pressure levels are below 130/80 mmHg. The Centers for Disease Control and Prevention estimates that 47% of adults in the United States have hypertension.

The incidence of hypertension varies by gender and race. About 50% of men have high blood pressure, whereas 44% of women have it. Hypertension rates are approximately 56% in black adults, 48% in white adults, 46% in Asian adults, and 39% in Hispanic adults. An African American aged 35 to her 64 is 50% more likely to have high blood pressure than a Caucasian.

Healthy Aging Research Data

Researchers examined data from 427 participants in the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study and the Study of Healthy Aging in African Americans (STAR). This yielded health data for a variety of older, black, Latino, and white adults in Asia from 1964 to 1985.

They obtained two blood pressure measurements from when participants were between 30 and 40 years of age. This allowed us to determine whether they had hypertension, transitioned to hypertension, or had normal blood pressure in young adulthood.

MRI scans of participants performed between 2017 and 2022 allowed us to look for late neuroimaging biomarkers of neurodegeneration and white matter integrity.

A significant reduction in cerebral gray mass is seen in both men and women with hypertension, although it is stronger in men.

Brain scan reveals difference

Brain scans in participants transitioning to hypertension or in hypertensive participants compared to participants with normal blood pressure showed changes in cerebral gray matter volume, frontal cortex volume, and partial anisotropy (brain connectivity). ) was shown to be low. Hypertensive men scored lower than women.

This study provides growing evidence that cardiovascular risk factors in young adulthood are detrimental to brain health later in life.

The researchers note that due to the sample size, they were unable to examine racial or ethnic differences, and recommend cautious interpretation of results regarding gender differences. We note that was only available from a single time point later in life. .

“This study really shows the importance of early age risk factors and shows that to age healthily, we need to take care of ourselves throughout our lives. Heart health is brain health,” said the study’s senior author Rachel Whitmer, professor of public health science and neurology and head of the division of epidemiology. She is also Associate Director of the Alzheimer’s Disease Center at the University of California, Davis.

“We are excited to continue to follow these participants and reveal more about what they can do at an early age to prepare themselves for healthy brain aging later in life,” Whitmer said. I got

Additional authors of this study include Pauline Maillard, Evan Fletcher, Dan M. Mungus, and Charles DeCari from the University of California, Davis. Paola Gilsanz, Kaiser Permanente Research Department. Rachel L. Peterson, University of Montana, Missoula. UCLA’s Joseph Fong and Elizabeth Rose Mayeda. L. Barnes of Rush Medical School. Her M. Maria Glymour of UCSF.

About this dementia research news

author: Lisa Howard
sauce: University of California, Davis
contact: Lisa Howard – University of California, Davis
image: image is public domain

Original research: open access.
“Association between early adult hypertension and blood pressure changes by neuroimaging biomarkers in old ageKristen M. George et al. JAMA network open

overview

Association between early adult hypertension and blood pressure changes by neuroimaging biomarkers in old age

Importance

The association between hypertension that develops before middle age and late-life brain health is poorly studied and may differ by gender because of the cardioprotective effects of estrogen before menopause.

the purpose

To assess the association of early adulthood hypertension and blood pressure (BP) changes with late neuroimaging biomarkers and explore potential gender differences.

design, setting, participants

This cohort study used data from the Healthy Aging Study in African Americans (STAR) and the Kaiser’s Healthy Aging and Diverse Life Experiences (KHANDLE) study. These studies were a matched longitudinal cohort of racially and ethnically diverse adults aged 50 and over in her San Francisco. Bay Area and Sacramento Valley in California. STAR ran from 6 November 2017 to 5 November 2021 and the KHANDLE study ran from 27 April 2017 to 15 June 2021. The current study included his 427 participants in his KHANDLE and STAR studies who underwent health assessments. Between June 1, 1964 and March 31, 1985. Between June 1, 2017 and March 1, 2022, regional brain volume and white matter (WM) integrity were measured via magnetic resonance imaging.

exposure

Hypertensive status (normotension, transition to hypertension, and hypertension) and blood pressure change (last measurement minus first measurement) are two pleiotropic variables in early adulthood (30 to 40 years). was assessed by the General Health Examination (MHC; 1964-1985).

Main achievements and countermeasures

Regional brain volume and WM integrity were assessed with 3T magnetic resonance imaging and Ze Standardized.General linear model adjusted for potential confounders (demographic characteristics and research [KHANDLE or STAR]) was used to assess the association between hypertension and blood pressure changes with neuroimaging biomarkers. Sexual interaction was tested.

result

Among the 427 participants, the median age (SD) was 28.9 (7.3) years at first MHC, 40.3 (9.4) years at last MHC, and 74.8 (8.0) years at neuroimaging. A total of 263 participants (61.6%) were female and 231 (54.1%) were black. Overall, 191 (44.7%) participants were normotensive, 68 (15.9%) transitioned to hypertension, and 168 (39.3%) were hypertensive.

Compared with normotensive participants, those with hypertension and those who transitioned to hypertension had smaller brain volumes (hypertension: β = -0.26 [95% CI, −0.41 to −0.10]transition to hypertension: β = −0.23 [95% CI, −0.44 to −0.23]), with similar differences in the amount of brain gray matter (hypertension: β = −0.32 [95% CI, −0.52 to −0.13]transition to hypertension: β = −0.30 [95% CI, −0.56 to −0.05]), frontal cortex volume (hypertension: β = −0.43 [95% CI, −0.63 to −0.23]transition to hypertension: β = −0.27 [95% CI, −0.53 to 0]), and parietal lobe volume (hypertension: β = −0.22 [95% CI, −0.42 to −0.02]transition to hypertension: β = −0.29 [95% CI, −0.56 to −0.02]). Hypertensive participants also had smaller hippocampal volumes (β = -0.22; 95% CI, -0.42 to -0.02) and larger ventricular volumes (lateral ventricles: β = 0.44). [95% CI, 0.25-0.63]3rd ventricle: β = 0.20 [95% CI, 0.01-0.39]), greater free water content (β = 0.35; 95% CI, 0.18-0.52), and lower fractional anisotropy (β = -0.26; 95% CI, -0.45 to -0.08) than normotensive individuals. was also low.

When hypertension was held constant, a 5 mm Hg increase in systolic blood pressure was associated with a decrease in temporal cortex volume (β = -0.03; 95% CI, -0.06 to -0.01), whereas diastolic A 5 mm Hg increase in blood pressure was associated. Small parietal lobe volume (β = -0.06; 95% CI, -0.10 to -0.02). In some regions, the negative associations between hypertension and changes in blood pressure and regional brain volume were stronger in men than in women.

Conclusion and relevance

In this cohort study, hypertension and blood pressure changes in early adulthood were associated with later volume and WM differences that are associated with neurodegeneration and dementia. Gender differences were observed in some brain regions, with hypertension and elevated blood pressure appearing to be more detrimental for men. These findings suggest that prevention and treatment of hypertension in early adulthood is important for brain health later in life, especially in men.