Summary: One of the latest studies shows that blood pressure fluctuation may increase the risk of cognitive decline (a drop in memory and thinking). The risk is greater in Black people. But you can shrink this risk with lifestyle changes and by taking medicine to control high blood pressure.
Blood pressure swings are not rare, but they are worse in some people. They are more common in older adults. Some people have normal blood pressure most of the time. But now and then it may rise or fall, like higher pressure on certain days or during stress. Swings are even more common in people with high blood pressure. Some people struggle to control their blood pressure because of the swings.
It is a known fact that high blood pressure raises the risk of brain disorders and cognitive decline. That is easy to guess. It happens mainly because the blood vessels get less healthy. High blood pressure also rarely shows up alone. It comes with other harmful metabolic changes, like bad blood fats (dyslipidemia). That raises the risk of cognitive decline even more. But one thing is still poorly understood. Do blood pressure swings also raise the risk of cognitive decline?
Yes. One of the latest and largest studies confirms that blood pressure swings are a risk factor for cognitive decline on their own. So even if you have mild high blood pressure, frequent swings raise your risk of cognitive decline. That, of course, means a higher risk of dementia.
This study was done in Chicago, US. Researchers followed 4770 people older than 65 for a long time. The study ran from 1993 to 2012. Researchers took their blood pressure on a regular basis. They found blood pressure swings of about 17.7 mmHg in Black people, who made up most of the group. Swings were 16 mmHg in White people. Blood pressure swings raised the risk of cognitive decline in every racial group. But the risk was greater in Black people.
There is a reason Black people are at greater risk. In fact, there are several: genes, bigger swings in blood pressure, poor access to health care, and more existing health problems. Black people in the study were also more likely to smoke and less likely to exercise. So this study showed that blood pressure swings are bad for brain health. It also showed gaps in health between groups.
Researchers also saw that people with the biggest swings had cognitive decline and brain aging about 2.8 years earlier than people with the smallest swings. One more point is key. Blood pressure swings raise the risk of faster brain aging and cognitive decline even in people with normal blood pressure. Researchers also saw that swings in the top number (systolic) and the bottom number (diastolic) have a similar effect. So even a person with normal blood pressure may have faster cognitive decline if either number swings.
But that is not all, and these problems can be beaten. In people taking blood pressure medicine, the swings did not cause cognitive decline. That shows why it matters to treat high blood pressure. But researchers also saw that Black people were more likely to skip medicine and live with poorly controlled high blood pressure.
Researchers say people need to know that blood pressure swings are a risk factor for cognitive decline. You can shrink this risk by taking your medicine every day. More studies are needed to see if blood pressure swings can predict the risk of cognitive decline. Swings usually start long before memory problems show up. So they might be used to predict the risk. Finally, we need to learn how swings within a single day affect brain health. Swings within the same day may well help predict the risk of cognitive decline too.
In short, remember that blood pressure control is not just about your heart. To reduce blood pressure swings, take your medicine every day, eat less salt, exercise, manage stress, and check your blood pressure often.
Frequently asked questions
Is fluctuating blood pressure dangerous?
Yes. One study followed 4,770 adults over 65 in Chicago from 1993 to 2012. Blood pressure that swung up and down was a risk factor on its own for cognitive decline and dementia. People with the biggest swings showed brain aging and cognitive decline about 2.8 years earlier than people whose pressure stayed steady.
Can fluctuating blood pressure hurt the brain if my blood pressure is normal?
Yes. The study found that swings in blood pressure sped up brain aging and cognitive decline. That held even in people whose average pressure was normal. Swings in the top number (systolic) and the bottom number (diastolic) did the same damage. A normal reading at one visit does not rule out the problem.
Is fluctuating blood pressure common in the elderly?
Yes. Blood pressure swings are more common in older adults. They are even more common in people with high blood pressure. Some people run normal most of the time and then spike on certain days or during stress. The swings usually start long before memory problems show up. That is why tracking them matters.
How do you fix fluctuating blood pressure?
Take your blood pressure medicine every day, cut back on salt, exercise, manage stress and check your pressure often. In the study, blood pressure swings did not lead to cognitive decline in people who took their medicine. Staying on treatment is what protects the brain.
Contact Us Today! Source: Briguglio, M. (2021). Nutritional Orthopedics and Space Nutrition as Two Sides of the Same Coin: A Scoping Review. Nutrients, 13(2), 483. https://doi.org/10.3390/nu13020483
Dr. Gurpreet Singh Padda, MD, MBA, MHP
