Blood pressure readings may help identify future dementia risk

Described a potential problem but offered NO SOLUTION! In the business world describing a problem with not even a hint of a solution would be immediate grounds for firing!

You've known of arterial stiffness problems for well over a decade AND DONE NOTHING!

• Arterial stiffness (32 posts to December 2014)

Send me personal hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name(If you can't stand by your name don't bother replying anonymously) and my response in my blog. Or are you afraid to engage with my stroke-addled mind? No excuses are allowed! You're medically trained; it should be simple to precisely state EXACTLY WHY you aren't solving blood pressure management protocols with NO EXCUSES! I've never received any communications from any stroke association. You'd think they would want to talk to their fiercest critic, but no, they are hiding under a rock someplace, probably don't even know I exist! Swearing at me is allowed, I'll return the favor. Don't even attempt to use the excuse that brain research is hard.

Blood pressure readings may help identify future dementia risk

Measures of blood vessel health derived from routine blood pressure readings may help identify adults at increased risk for dementia, according to research being presented at the American College of Cardiology's Annual Scientific Session (ACC.26). The findings from two studies that tracked patterns of arterial stiffness over time align with growing evidence that uncontrolled hypertension contributes to the development of dementia by accelerating the aging and stiffening of blood vessels.

Rates of dementia and aging-related cognitive decline are expected to increase as populations age. At the same time, nearly half of U.S. adults have high blood pressure, known as the "silent killer" because many people don't know they have it. Efforts to better address hypertension-a key contributor to heart disease and a risk factor for dementia-could impact both heart and brain health. The 2025 ACC/AHA Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults names blood pressure as the most prevalent and modifiable risk factor for the development of cardiovascular diseases, as well as dementia due to damage to blood vessels in the brain.

Blood pressure management(There are NO protocols to address this problem, so stop your fucking blathering and CREATE EXACT PROTOCOLS ON THIS!) isn't just about preventing heart attacks and strokes; it may also be one of the most actionable strategies for preserving cognitive health. We need to start thinking about hypertension management much earlier than we typically have in order to address this in younger adults before damage starts to accumulate."

Newton Nyirenda, MD, epidemiologist at Georgetown University, Washington and lead author of the studies

The two studies, by the same research team, highlight risk scores that identify patients who may be more likely to develop dementia. One study showed that pulse pressure-heart rate index-calculated from heart rate and blood pressure measurements-independently predicted the risk of dementia among adults over age 50. In a separate study, researchers found adults with persistently elevated or rapidly increasing estimated pulse wave velocity-a marker of vascular aging calculated from age and blood pressure-were significantly more likely to develop dementia compared with those with more stable vascular profiles.

"Our findings suggest that vascular aging patterns may provide meaningful insight into future dementia risk," said Nyirenda, MD. "This reinforces the idea that managing vascular health earlier in life may influence long-term brain health."

The studies analyzed 8,536 participants from the SPRINT trial, a large, multicenter study of adults aged 50 years and older with hypertension. Over follow-up, 323 participants developed probable dementia. Researchers examined pulse pressure-heart rate index and estimated pulse wave velocity patterns over five years.

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The results showed that participants with higher pulse pressure-heart rate index before age 65 years had a significantly higher risk of developing probable dementia or mild cognitive impairment, with each unit increase in pulse pressure-heart rate index being associated with a 76% higher risk. Participants with a higher estimated pulse wave velocity profile also had a higher risk of developing dementia, even after accounting for clinical risk factors such as age, sex, kidney disease, cardiovascular history, smoking and other factors.

Since the components of pulse pressure-heart rate index and estimated pulse wave velocity are routinely measured at primary care visits, researchers said that risk scoring based on either of these metrics should be relatively easy to integrate into clinical workflows. Discussing dementia risk in these terms could encourage more patients to reduce their risk by making lifestyle changes and taking medications if needed to lower blood pressure, Nyirenda said.

"Clinicians should focus on individualizing risk assessments and then tailoring treatment strategies that help patients improve cardiovascular health while preventing neurocognitive decline," said Sula Mazimba MD, associate professor at the University of Virginia and senior author. "You don't want to wait until a patient starts manifesting cognitive decline before you act."

As a post hoc analysis of clinical trial data, researchers said that the study cannot establish causation. Participants were adults with hypertension and elevated cardiovascular risk, so the findings may not generalize to lower-risk populations. Further studies are needed to validate clinically actionable thresholds and determine whether modifying vascular aging trajectories reduces dementia risk.

Source:

American College of Cardiology