Stages of Hypertension and Antihypertensive Medication Use in the Brain Health and Memory Clinic Setting

While mid-life hypertension is a recognised risk factor for dementia, data also suggest elevated blood pressure is detrimental to brain health. We aimed to determine the frequency of various stages of hypertensions and use of antihypertensive treatment, among participants attending an Australian brain health and memory clinic, and their association with neuropsychological functioning.

Older adults (age ≥50 years) with cognitive concerns underwent neuropsychological, mental health and geriatric medical assessments. Participants were classified based on systolic blood pressure (SBP) and diastolic blood pressure (DBP) into normal (SBP <120 mm Hg and DBP <80 mm Hg), elevated (SBP 120-129 mm Hg and DBP <80 mm Hg), stage 1 (SBP 130-139 mm Hg or DBP 80-89 mm Hg), and stage 2 (SBP ≥140 mm Hg or DBP ≥90 mm Hg) hypertension. Global cognition and age-corrected z-scores were computed for the neuropsychological domains of processing speed, verbal learning, verbal memory, executive function, and an overall composite.

Of 1,236 participants (mean age 67.7 years, 62% female), 84.7% were considered either stage 1 (31.7%) or stage 2 (53%) hypertension, but only 32.4% were taking antihypertensive treatment. The stage 2 hypertensive group was significantly older, had a higher mean body mass index, and higher comorbidities than the other groups (normal, elevated, and stage 1). No significant between-group differences were found in neuropsychological domains.

Hypertension (stages 1 and 2) is common, and use of antihypertensive medication is low, among attendees of a brain health and memory clinic. Efforts to screen and treat hypertension in a brain health and memory clinic setting appear justified, although further research is needed to better understand associated positive and negative effects of treatment in this patient group.