Higher Blood Pressure May Lead to Brain Shrinkage

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Having hypertension in midlife (ages 40 through 60) is associated with elevated risk of cognitive impairment and Alzheimer’s dementia later in life—even more so than having the so-called Alzheimer’s gene.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

“It is clear that [hardening of the arteries inside our brain] and cognitive decline travel hand in hand,” something I’ve addressed before. “However, the independent association of [Alzheimer’s] with multiple [atherosclerotic vascular disease] risk factors suggests that cholesterol is not the sole culprit in dementia.”

One of the “most consistent finding[s]” is “elevated…levels of blood pressure” in “mid-life”, (meaning ages 40 through 60) is associated with elevated risk of cognitive impairment and Alzheimer’s dementia later in life. In fact, even more so than having the so-called Alzheimer’s gene.

“The normal arterial tree”—all the blood vessels in the brain—”…is designed as both a conduit and cushion.” But, when the artery walls become stiffened, every time our heart pumps blood up into our brain, the pressure from the pulse can damage small vessels in our brains. This can cause what are called “microbleeds” in our brain, which are frequently found in people with high blood pressure—even if they were never diagnosed with a stroke.

These microbleeds may be “one of the important factors that cause cognitive impairments”—perhaps not surprisingly, because on autopsy, “microbleeds may be associated with [brain] tissue necrosis,” meaning brain tissue death.

And, speaking of tissue death, high blood pressure is also associated with so-called “lacunar infarcts”—from the Latin word lacuna, meaning hole. Holes in our brain that appear when little arteries get clogged in our brain, and result in the death of a little round region of the brain. Up to a quarter of the elderly have these little ministrokes, and most don’t even know it—so-called silent infarcts, but “no black holes in the brain are benign.” This is what they look like—it’s like your brain has been hole-punched.

Although silent infarcts, by definition, lack…overt stroke-like symptoms, they are associated with subtle deficits in physical and cognitive function that commonly go unnoticed.” And, they can “[double] the risk of…dementia.” That’s one of the ways high blood pressure is linked to dementia.

So much damage that “high [blood pressure] levels [can] lead to brain volume reduction,” literally a shrinkage of our brain—”specifically in [the] hippocampus,” the memory center of the brain. This helps explain how high blood pressure can be involved in the development of Alzheimer’s disease.

One can actually visualize the little arteries in the back of our eyes, using an ophthalmoscope, providing “a noninvasive window to study” the health of one’s intracranial arteries, the little vessels inside our head. The researchers found “a significant association” between arterial disease and brain shrinkage on MRI.

But, this was a cross-sectional study, just a snapshot in time; so, you can’t prove cause and effect. What you need is a prospective study, following people over time; and so, that’s what they did. Over a ten-year period, those with signs of arterial disease were twice as likely to suffer a significant loss of brain tissue volume over time.

Please consider volunteering to help out on the site.

Image credit: KlausHausmann via pixabay. Image has been modified.

Video credit: Tyler McReynolds, Teetotalin LLC.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

“It is clear that [hardening of the arteries inside our brain] and cognitive decline travel hand in hand,” something I’ve addressed before. “However, the independent association of [Alzheimer’s] with multiple [atherosclerotic vascular disease] risk factors suggests that cholesterol is not the sole culprit in dementia.”

One of the “most consistent finding[s]” is “elevated…levels of blood pressure” in “mid-life”, (meaning ages 40 through 60) is associated with elevated risk of cognitive impairment and Alzheimer’s dementia later in life. In fact, even more so than having the so-called Alzheimer’s gene.

“The normal arterial tree”—all the blood vessels in the brain—”…is designed as both a conduit and cushion.” But, when the artery walls become stiffened, every time our heart pumps blood up into our brain, the pressure from the pulse can damage small vessels in our brains. This can cause what are called “microbleeds” in our brain, which are frequently found in people with high blood pressure—even if they were never diagnosed with a stroke.

These microbleeds may be “one of the important factors that cause cognitive impairments”—perhaps not surprisingly, because on autopsy, “microbleeds may be associated with [brain] tissue necrosis,” meaning brain tissue death.

And, speaking of tissue death, high blood pressure is also associated with so-called “lacunar infarcts”—from the Latin word lacuna, meaning hole. Holes in our brain that appear when little arteries get clogged in our brain, and result in the death of a little round region of the brain. Up to a quarter of the elderly have these little ministrokes, and most don’t even know it—so-called silent infarcts, but “no black holes in the brain are benign.” This is what they look like—it’s like your brain has been hole-punched.

Although silent infarcts, by definition, lack…overt stroke-like symptoms, they are associated with subtle deficits in physical and cognitive function that commonly go unnoticed.” And, they can “[double] the risk of…dementia.” That’s one of the ways high blood pressure is linked to dementia.

So much damage that “high [blood pressure] levels [can] lead to brain volume reduction,” literally a shrinkage of our brain—”specifically in [the] hippocampus,” the memory center of the brain. This helps explain how high blood pressure can be involved in the development of Alzheimer’s disease.

One can actually visualize the little arteries in the back of our eyes, using an ophthalmoscope, providing “a noninvasive window to study” the health of one’s intracranial arteries, the little vessels inside our head. The researchers found “a significant association” between arterial disease and brain shrinkage on MRI.

But, this was a cross-sectional study, just a snapshot in time; so, you can’t prove cause and effect. What you need is a prospective study, following people over time; and so, that’s what they did. Over a ten-year period, those with signs of arterial disease were twice as likely to suffer a significant loss of brain tissue volume over time.

Please consider volunteering to help out on the site.

Image credit: KlausHausmann via pixabay. Image has been modified.

Video credit: Tyler McReynolds, Teetotalin LLC.

Doctor's Note

What can we do about high blood pressure? A lot! See, for example:

What else can we do to forestall cognitive decline or dementia? I referenced my video Alzheimer’s and Atherosclerosis of the Brain earlier, and here are other videos that offer information on treatment and prevention:

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