Worried About Dementia? You Might Want to Check Your Blood Pressure

Jul 16, 2018
Originally published on July 17, 2018 12:30 pm

Every day, Dr. Walter Koroshetz, 65, takes a pill as part of his effort to help keep his brain healthy and sharp.

The pill is his blood pressure medication. And Koroshetz, who directs the National Institute of Neurological Disorders and Stroke, says controlling high blood pressure helps him reduce his risk of dementia.

He also keeps his blood pressure down by exercising and paying attention to his weight and diet. "I'm a believer," he says.

Koroshetz is urging other people with high blood pressure to follow his lead.

He is responsible for the institute's public health campaign called Mind Your Risks. Its goal is to let people know that there is a link between high blood pressure, stroke and dementia.

When blood pressure rises, it strains the tiny blood vessels that keep brain cells alive, Koroshetz says.

"With every pulse of your heart, you are pushing blood into these very small blood vessels in the brain," he says. And when the heart pushes too hard, as it does when blood pressure is elevated, it can cause damage that can lead to a stroke.

At least two large studies have revealed an alarming trend among stroke patients, Koroshetz says.

"If you had a stroke, even a small stroke, your risk of dementia within the next two years was greatly magnified," he says. "So there's something about having a stroke that drives a lot of the processes that give rise to dementia."

The evidence is clearest for a type of dementia called vascular dementia. It occurs when something blocks or reduces the flow of blood to brain cells.

But high blood pressure also appears to increase a person's risk of developing Alzheimer's disease, which is associated with the accumulation of plaques and tangles in the brain.

If people knew about the link between dementia and high blood pressure, they might be more inclined to do something about it, Koroshetz says.

"Only about 50 percent of people who have hypertension are actually treated," he says. "So I think there's a lot to be said for trying to get high blood pressure under control."

Koroshetz's campaign is getting some help from the Alzheimer's Association.

The group will present new research on blood pressure and Alzheimer's at its annual scientific meeting in Chicago, which starts July 22. And the group is encouraging people to control high blood pressure.

"The good news is that we can control blood pressure now," says Maria Carrillo, the group's chief science officer. "We can do that with exercise, with lifestyle, with healthy eating and also with medications."

Koroshetz is using all of these approaches. And he says other people with high blood pressure should follow his lead.

"When you get to be my age, you're going to be very grateful that you controlled your blood pressure and exercised," he says.

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NOEL KING, HOST:

There's growing evidence that when your blood pressure goes up, so does your risk of developing dementia, so one of the country's top brain doctors is urging people to protect their brains by controlling their blood pressure. As NPR's Jon Hamilton reports, this particular doctor is leading by example.

JON HAMILTON, BYLINE: Every day, Dr. Walter Koroshetz takes some pills to help his brain stay healthy and sharp.

WALTER KOROSHETZ: I have to take my blood pressure medicines. I do (laughter).

HAMILTON: You're practicing what you preach here.

KOROSHETZ: Yeah. Oh, yeah, absolutely. I'm a believer. Right.

HAMILTON: Koroshetz should know. He's the director of the National Institute of Neurological Disorders and Stroke. And he's running a public health campaign called Mind Your Risks to tell people about the link between high blood pressure, stroke and dementia. Koroshetz says when blood pressure rises, it puts too much pressure on the tiny blood vessels that keep brain cells alive.

KOROSHETZ: With every pulse of your heart, you are pushing blood into these very small blood vessels in the brain and dilating them over and over again, which finally causes them to become diseased, to break, even.

HAMILTON: Koroshetz says that can lead to a stroke. And he says at least two large studies found an alarming trend among stroke patients.

KOROSHETZ: If you had a stroke - even a small stroke - your risk of dementia within the next two years was greatly magnified. So there's something about having a stroke that drives a lot of the processes that give rise to dementia.

HAMILTON: Koroshetz says the evidence is clearest for a type of dementia caused by problems with blood flow in the brain, but high blood pressure also appears to increase a person's risk of developing Alzheimer's disease. Koroshetz says if people knew about the link between dementia and high blood pressure, they might be more inclined to do something about it.

KOROSHETZ: Only about 50 percent of people who have hypertension are actually - treat it, so I think there's a lot to be said for trying to get high blood pressure in control.

HAMILTON: Koroshetz is getting some help from the Alzheimer's Association. The group will present new research on blood pressure and Alzheimer's at its meeting in Chicago next week, and the group's chief science officer, Maria Carrillo, says the association is spreading the word that there are lots of ways to reduce blood pressure.

MARIA CARRILLO: We can do that with exercise, with lifestyle, with healthy eating and also with medications.

HAMILTON: Maintaining a healthy weight also helps. Koroshetz is using all of these approaches, and he says other people with high blood pressure should follow his lead.

KOROSHETZ: When you get to be my age, you're going to be very grateful that you controlled your blood pressure and exercised. You know, even 15 minutes a day is all it takes.

HAMILTON: Jon Hamilton, NPR News.

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