Treating hypertension lowers risk of dementia: Study

A new study published in Nature Medicine this week shows medication to lower blood pressure in people with untreated hypertension significantly decreases their risk of dementia.
 
Researchers from the United States and China used data from around 34,000 people living in rural China, with participants in the study aged 40 years and over with untreated hypertension. They were randomised into an intervention and a control group.
 
Over four years, those in the intervention group (17,407 patients), received blood pressure medication alongside health coaching on home blood pressure monitoring and healthy lifestyles, as well as support to take their medications consistently.
 
The researchers found those in the intervention group achieved better blood pressure control, with more patients reaching target levels, than the control group.
 
They also experienced a significant 15% reduction in risk of all-cause dementia, while their risk of cognitive impairment was cut by 16%.
 
In Australia, dementia is the leading cause of death for women  and the second leading cause overall. It is the leading cause of disability for older Australians.
 
Dr Marita Long, a Victorian GP with a special interest in dementia and honorary medical advisor with Dementia Australia, said hypertension is now well established as a risk factor for dementia.
 
‘This article highlights that the target blood pressure is a bit lower than what we tend to accept for cardiovascular disease prevention, sitting at 130/80 as opposed to 140/90,’ she told newsGP.
 
‘We [GPs] probably need to be a bit more enthusiastic in treating high blood pressure for dementia prevention.
 
‘I would go a bit further and suggest we really look at women and mid-life blood pressure, given women are twice as likely as men to be diagnosed with dementia.’
 
Dr Long said GPs are skilled at managing high blood pressure through both pharmacological and non-pharmacological approaches, and that these skills can be used more broadly.
 
‘It’s very important to not forget that there are multiple modifiable risk factors for dementia prevention and there is evidence that multi-domain interventions are more effective at reducing risk,’ she said.
 
‘There are 14 established modifiable risk factors that can prevent or at least delay the onset of dementia and we have some good evidence that implementing multiple interventions to modify risk can make a difference.’
 
Dr Long also highlighted CogDrisk, developed by UNSW, as an ‘incredibly useful tool’ to assess an individual’s risk for dementia, as well as to guide risk reduction and identify vulnerable groups to monitor for early cognitive change.
 
The Australian Institute of Health and Welfare estimates there were 411,100 Australians living with dementia in 2023, and it is predicted this number will more than double by 2058 to around 850,000 – including 533,800 women and 315,500 men.
 
Research suggests people with untreated hypertension experience a 42% greater risk of developing dementia compared with those without untreated hypertension.
 
The study’s authors say their work highlights the potential for similar comprehensive untreated hypertension interventions being used more broadly to help prevent dementia.
 
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dementia dementia prevention dementia risk factors health education hypertension