Harvard Heart Letter

How better blood pressure control may benefit the brain

Research we’re watching

Treating high blood pressure may do more than prevent heart attacks and strokes. In older adults, intensive blood pressure lowering may also conserve brain function, according to a new study.

Published online Oct. 14, 2019, by the journal Circulation, the study included 199 adults ages 75 and older, all with a systolic blood pressure value (the first number in a reading) of 150 or higher. Their brain scans also showed lesions in the brain’s white matter, which contains nerve fibers that send signals from one part of the brain to another. The lesions, which reflect damaged small blood vessels, have been linked to a propensity for thinking and memory problems. About two-thirds of people over age 75 have white matter lesions, as do most people over age 90.

Half of the participants were given medications to lower their systolic blood pressure to 145, while the others got medications to reach a goal of 130 or lower. Three years later, brain scans showed fewer new lesions in the white matter of people whose systolic blood pressure was 130 or lower than in those whose blood pressure target was 145. Effective blood pressure control may be an important way to preserve brain function as people age, according to the study authors.

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