Summary: One of the latest studies shows that blood pressure fluctuation may increase the risk of cognitive decline. Further, this risk is greater in Blacks. However, this risk can be minimized through lifestyle interventions and taking medications to manage hypertension.
Blood pressure fluctuation is not rare, but it is more severe in some individuals. It is relatively more common in older adults. Some people have normal blood pressure most of the time, but they might experience fluctuations like an increase or decline in blood pressure from time to time, like higher blood pressure on certain days or during periods of stress. However, blood pressure fluctuations are even more common in those living with hypertension. Some individuals struggle to control their blood pressure due to the fluctuations.
It is an established fact that hypertension increases the risk of brain disorders or cognitive decline. That is easy to guess, as this occurs mainly due to declining vascular health. Moreover, hypertension rarely exists alone, but rather along with other adverse metabolic changes like dyslipidemia, further increasing the risk of cognitive decline. However, among all these issues, one thing remains poorly understood: do blood pressure fluctuations also increase the risk of cognitive decline?
Yes, one of the latest and most extensive studies confirms that blood pressure fluctuation is an independent risk factor for cognitive decline. This means that even if one has mild hypertension, if there are frequent fluctuations in the blood pressure, the risk of cognitive decline is higher. This naturally means an increased risk of dementia.
The present study was conducted in Chicago, US, where 4770 individuals older than 65 were followed up for a long time. The study lasted from 1993 to 2012. In the study, researchers regularly took their blood pressure. Researchers found that participants had blood pressure fluctuation of about 17.7 mmHg in Black individuals, who also formed the majority of the participants. Blood pressure fluctuation was 16 mmHg in White participants. The study found that blood pressure fluctuations increased cognitive decline risk irrespective of racial background, but such a risk was greater in Blacks.
There is a reason why Blacks are at a greater risk. This higher risk is due to multiple reasons like genetics, greater fluctuation of blood pressure, poor access to healthcare, and a greater number of pre-existing health issues. Moreover, Blacks were more likely to smoke and engage less in physical activity. So, this study showed that blood pressure fluctuation is bad for brain health and identified health disparities.
Investigators also noticed that those with the highest fluctuation levels experienced cognitive decline and brain aging about 2.8 years earlier than those with minimal blood pressure fluctuation. One more thing is vital to note: blood pressure variance increases the risk of faster brain aging and cognitive decline, even in those living with normal blood pressure. Additionally, they also noticed that both systolic and diastolic blood pressure fluctuations have similar effects. So, it means that even a person with normal blood pressure may experience faster cognitive decline if they have fluctuating diastolic or systolic blood pressure.
But that is not all, and these issues can be overcome. The study found that blood pressure variance did not cause cognitive decline in those taking blood pressure medications. This underlines the importance of managing hypertension. However, they also noticed that Blacks were more likely not to take medications and be living with poorly controlled hypertension.
Researchers say that people need to be aware that blood pressure variance is a risk factor for cognitive decline. This risk can be minimized by taking medications regularly. There is also a need for more studies to understand if blood pressure variance can be used to predict the risk of cognitive decline. Generally, blood pressure fluctuation starts happening much before one starts experiencing cognitive decline. This means that blood pressure fluctuation might be used to predict the risk. Finally, there is also a need to understand how blood pressure fluctuation during the day influences brain health. It is quite likely that blood pressure variance within the same day may also help predict the risk of cognitive decline.
In short, one should remember that managing blood pressure is not just about heart health. So, to reduce blood pressure variance, take medications regularly, reduce salt intake, exercise, manage stress, and monitor your blood pressure regularly.
Frequently asked questions
Is fluctuating blood pressure dangerous?
Yes. In a study that followed 4,770 adults over 65 in Chicago from 1993 to 2012, blood pressure that swung up and down was an independent risk factor 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 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 and even more common in people living 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, which is why tracking them matters.
How do you fix fluctuating blood pressure?
Take your blood pressure medication every day, cut back on salt, exercise, manage stress and check your pressure regularly. In the study, blood pressure swings did not lead to cognitive decline in people who took their blood pressure medication. 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
