Discontinuing high blood pressure treatment in seniors with mild memory and thinking problems did not improve their mental functioning, a new study shows.
It’s known that high blood pressure during middle age is a risk factor for cerebrovascular disease — impaired blood flow in the brain. But the effect of high blood pressure on the brain during old age is less clear, the research team said. In fact, some studies have suggested that lower blood pressure in old age, rather than higher blood pressure, might boost a person’s odds for mental decline.
So, the new study focused on whether discontinuing high blood pressure medications might make any difference to an older person’s thinking and memory.
The question is worth asking, one expert said.
“Patients frequently question whether medications such as cholesterol- and blood pressure-lowering therapy contribute to memory impairment,” said Dr. Kevin Marzo, chief of cardiology at Winthrop-University Hospital in Mineola, N.Y.
The new study, published online Aug. 24 in the journal JAMA Internal Medicine, included 385 people, aged 75 and older. All had mild memory and thinking problems and were taking high blood pressure medications. None had serious heart disease, however.
Half of the participants were randomly selected to stop their high blood pressure treatment, while the other half continued their medication. Both groups were followed for four months, according to a team led by Dr. Justine Moonen, of Leiden University Medical Center in the Netherlands.
However, by the end of that time, the Dutch team saw no improvement in the participants’ mental functioning, whether they stopped the medications or not.
The researchers said there are a number of possible reasons why halting high blood pressure treatment had no effect on brain function, including the fact that none of the participants had serious heart disease.
Dr. Luca Giliberto is an investigator at the Litwin-Zucker Research Center for the Study of Alzheimer’s Disease, part of the Feinstein Institute for Medical Research in Manhasset, N.Y. He said that the issue of blood pressure control and mental function in the elderly is worth looking into, because the vessels that supply blood to the brain deteriorate with advancing age.
“Our brain becomes less able to adapt to varying blood pressure, both high and low,” Giliberto explained. Episodes of high blood pressure might trigger “mini-strokes” that could impair mental function, he said, while episodes of low blood pressure might hamper cerebral blood supply. All of this might end up contributing to declines in memory and thinking, Giliberto said.
But he added that the study has its limitations, especially because people with serious heart disease were not studied. And he believes that the study period may have been too short for any real effect to become apparent.
According to the researchers, future studies with longer follow-up might help determine if seniors with poor blood circulation in the brain could benefit from more relaxed blood pressure targets.
The U.S. National Institute on Aging has more about seniors and high blood pressure.