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Optimal Blood Pressure Keeps Our Brains Younger
Nicolas Cherbuin1, Erin I Walsh1, Marnie Shaw2
1Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, ACT, Australia.
Insights
Elevated blood pressure (BP) is linked to accelerated brain aging, even before hypertension develops. Maintaining ideal BP may result in a brain appearing over six months younger at midlife.
Area of Science:
- Neuroscience
- Cardiovascular Health
- Aging Research
Background:
- Elevated blood pressure (BP) is a leading global cause of premature death and a risk factor for cognitive decline and dementia.
- The precise timing of when elevated BP impacts cerebral health remains unclear.
- This study investigates the relationship between longitudinal changes in BP and brain health.
Purpose of the Study:
- To estimate how a validated measure of brain health relates to changes in blood pressure over 12 years.
- To determine if elevated blood pressure impacts brain health across the entire BP range, not just in hypertensive individuals.
Main Methods:
- Utilized a machine learning approach to estimate "observed" brain age (BrainAGE) in cognitively intact middle-aged and older adults.
- Assessed longitudinal associations between blood pressure and BrainAGE using linear mixed-effects models over a 12-year period.
- Included participants aged 44-64 years at baseline with up to four brain scans.
Main Results:
- Observed a progressive increase in mean, systolic, and diastolic blood pressure over the follow-up period.
- Each 10 mmHg increase in blood pressure was associated with a BrainAGE increase of 51-66 days.
- These effects were present across the entire blood pressure range, not solely driven by hypertension.
Conclusions:
- Increasing blood pressure is associated with poorer brain health, indicated by accelerated brain aging.
- Individuals with ideal blood pressure may have brains that appear significantly younger compared to those with elevated BP.
- Early and consistent management of blood pressure is crucial for preserving brain health across the lifespan.
Abstract:
Background: Elevated blood pressure (BP) is a major health risk factor and the leading global cause of premature death. Hypertension is also a risk factor for cognitive decline and dementia. However, when elevated blood pressure starts impacting cerebral health is less clear. We addressed this gap by estimating how a validated measure of brain health relates to changes in BP over a period of 12 years. Methods: Middle-age (44-46 years at baseline, n = 335, 52% female) and older-age (60-64 years, n = 351, 46% female) cognitively intact individuals underwent up to four brain scans. Brain health was assessed using a machine learning approach to produce an estimate of "observed" age (BrainAGE), which can be contrasted with chronological age. Longitudinal associations between blood pressures and BrainAGE were assessed with linear mixed-effects models. Results: A progressive increase in BP was observed over the follow up (MAP = 0.8 mmHg/year, SD = 0.92; SBP = 1.41 mmHg/year, SD = 1.49; DBP = 0.61 mmHg/year, SD = 0.78). In fully adjusted models, every additional 10 mmHg increase in blood pressure (above 90 for mean, 114 for systolic, and 74 for diastolic blood pressure) was associated with a higher BrainAGE by 65.7 days for mean, and 51.1 days for systolic/diastolic blood pressure. These effects occurred across the blood pressure range and were not exclusively driven by hypertension. Conclusion: Increasing blood pressure is associated with poorer brain health. Compared to a person becoming hypertensive, somebody with an ideal BP is predicted to have a brain that appears more than 6 months younger at midlife.
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