14 March 2017

A blood pressure monitor can warn about an increased risk of dementia

Falling blood pressure when getting up is associated with the risk of developing dementia

Anna Stavina, XX2 century

Hundreds of millions of people around the world suffer from various forms of dementia or dementia (including Alzheimer's disease). The authors of a new study concluded that sharp drops in blood pressure (BP) in middle age indicate an increased risk of dementia or cognitive impairment in old age.

Alzheimer's disease, the most common form of dementia, is the sixth most common cause of death in the United States. According to statistics, by the end of life, this disease occurs in every third elderly American. The results of the new work, during which it was possible to find a link between episodes of lowering blood pressure and the further development of dementia, were presented at the Scientific Sessions on Epidemiology, Prevention and Lifestyle 2017 (Epidemiology and Prevention/ Lifestyle 2017 Scientific Sessions) of the American Heart Association. The study was conducted on the basis of the Johns Hopkins Bloomberg School of Public Health at Johns Hopkins University.

Constantly low blood pressure can cause dizziness and fainting, as well as the appearance of a feeling of weakness or nausea. But there are also cases of a sharp drop in blood pressure caused by a change in the position of the body in space. They were called "orthostatic hypotension". Orthostatic hypotension disrupts the blood supply to the brain and can cause serious harm to health.

Previous studies have demonstrated the presence of a link between episodes of rapid blood pressure decline and cognitive impairment in the elderly. But the head of the new work, the postdoc of the Department of Epidemiology from the Bloomberg School, Andrea Rawlings and her colleagues, for the first time tried to trace a long-term connection between these phenomena.

Scientists analyzed the data of 15,792 people who took part in the study of the risk of atherosclerosis at their place of residence (Atherosclerosis Risk in Communities). At the time of the beginning of work, in 1987, the volunteers were from 45 to 64 years old. The sample of the new study included information about the health status of 11503 people who did not suffer from cardiovascular diseases and visited the hospital for the first time to participate in the study.

As part of the work, the scientists drew attention to the blood pressure indicators of the volunteers, measured after they spent 20 minutes lying down. Orthostatic hypotension, or a sharp drop in blood pressure, was designated as a decrease in systolic pressure by 20 mmHg or more or a decrease in diastolic pressure by 10 mmHg or more. The results of a survey of 703 volunteers out of 11503 previously selected fit this definition.

The researchers tracked further changes in the condition of these people for 20 years or more. It turned out that the study participants who suffered from orthostatic hypotension at the time of the first visit to the clinic had a 40% higher risk of developing dementia than the rest of the volunteers. The decrease in cognitive functions in this subgroup was also more pronounced – the difference was 15%.

"Although these episodes are often short-lived, their effects can be long-lasting. We found that people who had a drop in blood pressure in middle age were more likely to suffer from dementia in old age. This is an important observation, and we need to learn more about what exactly happens when this happens," explains Andrea Rawlings (see the press release Rapid Blood Pressure Drops In Middle Age Linked to Dementia in Old Age – VM).

Since the study was observational in nature, the authors were unable to establish a causal relationship or say whether orthostatic hypotension is a sign of another disease that causes cognitive impairment. However, as the scientists emphasized, an important role could be played by a violation of the blood supply to the brain.

Rawlings also noted another limitation of the study – based on the available data, it was not possible to establish whether the episode of orthostatic hypotension recorded during the examination was the only one, or the participants experienced blood pressure drops regularly.

"The detection of risk factors for cognitive impairment and dementia is important for a better understanding of the development of these diseases. In addition, identifying the most at–risk groups can help us develop preventive and therapeutic strategies," Rawlings explains.

Portal "Eternal youth" http://vechnayamolodost.ru  14.03.2017

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