Having High Blood Pressure Can Speed Up Cognitive Decline—Here Are 4 Ways to Combat Both, According to Doctors

Try these 4 tactics if you have hypertension (or a family history of it).

A fading brain with a blood pressure gauge coming out of it
Photo: Getty Images / SCIEPRO / IPGGutenbergUKLtd

True, your body is made up of many different systems (such as the circulatory system and the nervous system). But there's not a hard line separating each. The more we learn about the body, the more we realize all of our cells are remarkably connected, working in tandem. Gut health relates to stress and anxiety levels, what we eat can impact our hair hue, a COVID-19 case may impact long-term cognition and so much more.

Two systems that are super-in-sync—good or bad—are the head and the heart. As we've mentioned before, all of the major risk factors for heart disease overlap with Alzheimer's disease risk factors, just tack on a few more cognition and social factors for the latter. So it aligns that new research published in the journal Hypertension confirmed that high blood pressure can speed up memory loss and other forms of cognitive decline in middle-aged adults and seniors, even if the blood pressure elevation occurs only early or only late in life.

Brain Health and Blood Pressure 101

"Heart health and brain health are tightly interconnected. An estimated 25% of the blood pumped out of the heart flows through the brain, so any condition that impairs cardiovascular health will have negative impacts on the function of our other organs," explains David Amstel, M.D., a cardiologist at Westmed Medical Group in Yonkers, New York.

Hypertension, or a blood pressure over 130/80 mm Hg per the American Heart Association criteria, is particularly damaging to brain function and is known to cause strokes and certain forms of dementia, Amstel says.

"High blood pressure is also linked to impairments of cognition, learning and memory. Recent data suggests this effect is true no matter how long a patient is hypertensive or at what age hypertension begins," he says.

Our blood pressure range is critical to the entire body's functioning, adds Michael Silver, M.D., a cardiologist and internal medicine physician at Westmed Medical Group in White Plains, New York.

"Elevated blood pressure leads to more strain on the blood vessel walls. This causes blood vessel walls to thicken and promotes entry of cholesterol into the walls, which narrows the passage of blood into these organs," Silver says. "Both the heart and brain are organs that depend on an adequate blood flow to provide nutrition and oxygenation for their activity."

Lower blood flow can cause either improper function or, and if severe, the death of certain areas of the heart and brain (known respectively as heart attack or stroke). And the wild part is, some of these brain-harming strokes can be so subtle that we might not even be aware they're happening.

"Hypertension is a very important risk factor in 'silent strokes,' which can lead to cognitive decline. It depends on in what part of the brain you're having the stroke; different regions control speech, movement and memory. A lot of these strokes might be subclinical, but these 'mini' or 'silent' strokes can be severe if they occur at a high frequency," says Salim S. Virani, M.D., Ph.D., a professor of cardiology at Baylor College of Medicine in Houston.

What Doctors Want You to Know About Hypertension

Hypertension is one of the most common medical conditions in the United States; an estimated 45% to 50% of adults have the diagnosis, according to the latest data from the Centers for Disease Control and Prevention.

"There are many causes, including obesity, sedentary lifestyle, smoking, poor dietary habits, excess alcohol intake and stress. Age, race and family history are also strong contributors," Amstel says.

In 95% of those diagnosed with hypertension, doctors cite the cause as "idiopathic," Silver says, "meaning there is no identifiable cause. In the other 5%, causes such as kidney disease, benign tumors of the adrenal gland, vascular disease, sleep apnea and thyroid disease may exist."

If you are among the 1 in 2 Americans with high blood pressure, received a borderline high reading at your latest physical or have a family history of hypertension, the good news is that a lot of the power lies in your hands, Amstel says: "Patients should take active roles in their health care to prevent hypertension."

Whether you decide to take charge for your heart health only or are worried about your dementia risk too, there's no wrong reason to try shifting toward healthier lifestyle patterns, the doctors agree.

4 Lifestyle Changes to Keep Your Blood Pressure in Check—and Your Brain Healthy

"Since elevated blood pressure causes no 'symptoms'—it is a silent disease and can change over time—regular trips to the doctor for evaluation are important," Silver says.

Visit your primary care doctor at least once every year for a physical and blood pressure check. Blood pressure medication will almost always be a plan B after you try these lifestyle modifications to potentially lower blood pressure naturally, Virani adds.

1. Move your body.

Aim to accumulate 150 minutes of moderate or 75 minutes of vigorous physical activity per week, per World Health Organization and AHA recommendations. But don't feel intimidated if you can't meet that mark right away, Virani says. "Physical activity is very effective in lowering blood pressure. Taking any time for physical activity is better than no time. Those who start as sedentary and get more activity than zero are still achieving some benefits."

2. Keep alcohol intake moderate.

Cutting down on alcohol to two drinks per day for men and one drink for women (or less) can be an easy way to move the needle. (Psst ... here's a refresher on what counts as "one drink.")

3. Eat less sodium and more potassium.

This will help the body maintain proper fluid balance and blood volume so it can function well. Opt for fresh or dried herbs and spices to flavor dishes, go for low-sodium versions of foods when grocery shopping and try to cut back on packaged foods that are high in sodium in general. Potassium is found in a lot of foods, particularly fruits and vegetables, in addition to dairy items, beans and some meats. Try this healthy high-blood pressure meal plan for beginners.

4. Check with your doctor about losing weight.

Your doctor can help you determine if losing weight might be beneficial for your blood pressure. "Research suggests that a 1-kilogram [2.2-pound] weight loss may lower blood pressure by 5 mm Hg," Virani says. A healthy whole-foods, plant-forward diet is beneficial, Amstel says. (ICYMI, here's how to lose weight when you don't know where to start, according to a dietitian.)

Bottom line

"Based on our race and ethnicity, we may be more sensitive to one or another lifestyle modifications; try them each and see which works best," Virani says. As a bonus nugget of motivation, he adds that "these are not just good for blood pressure-lowering, they also reduce risk for stroke, improve cognition, reduce the risk of cancers, improve heart health and more. There are many benefits related to healthy lifestyle choices."

The more love you give to your heart, the more your brain will benefit. Keeping your blood pressure in a healthy range is good for so many reasons, with brain health being an important one. Eat more whole foods, particularly potassium-rich fruits and veggies, while decreasing the amount of sodium in your diet. Keep alcohol intake to a minimum, move your body regularly and talk to your doctor to see is losing weight would be beneficial.

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