Individuals who suffer from high blood pressure are at higher risk of mental decline versus individuals who do not suffer from high blood pressure. The medical community has always felt that treating individuals suffering from high blood pressure with drugs will reduce their risk of mental decline as well as their risk of a stroke and heart attack.
This is proving to be a false hope based on recent research. The exact opposite may in fact be true; individuals who are aggressively treated with high blood pressure medications seem to be suffering greater mental decline as well as actual brain shrinkage.
172 patients, mean age 79, attended memory clinics. All of them either had mild cognitive impairment or dementia. About 70% were being treated for high blood pressure. The patients with blood pressures under 130 had a larger drop in mental abilities versus those with blood pressures between 130 and 145. The authors concluded that excessive blood pressure lowering may be harmful in older patients with cognitive problems.
It only gets worse
In an analysis of the ACCORD Trial which studied aggressive treatment of risk factors in diabetics, blood pressure medications showed no evidence of slowing cognitive decline. What aggressive use of high blood pressure medications did demonstrate was an increased rate of brain shrinkage.
The total brain volume of those treated aggressively with medications shrank significantly more than those who were not aggressively treated. The ACCORD Trial was stopped early due to higher overall death rates as a result of the aggressive medication treatment they were receiving for blood sugar control as well as high blood pressure.
Physicians in general look at a patient’s numbers to determine the success or failure of a treatment. Many, unfortunately, do not realize that behind those numbers is a human being who frequently has become dysfunctional as a result of the treatment.
JAMA Internal Medicine: Effects of Low Blood Pressure in Cognitively Impaired Elderly Patients
MedPage Today: Diabetes and Dementia: No Benefit from BP Control