Harvard Health Publications (August 7, 2014): High Blood Pressure in Midlife linked to Later Decline in Memory, Thinking Skills

Publication Date: 
Thu, 08/07/2014

Fleetwood Mac’s hit song, “Don’t stop thinking about tomorrow,” got a second life as the anthem for then-candidate Bill Clinton’s first campaign for President. A new report in JAMA Neurology may trigger the return of that earworm. The report offers yet another reminder that tomorrow may not be better if you have uncontrolled high blood pressure.

Researchers with the long-term Atherosclerosis Risk in Communities (ARIC) Neurocognitive Study followed the health and mental function of nearly 13,500 men and women for more than 20 years. All of the participants were between the ages of 45 and 64 years when the study began; 76% were white and 24% were African-American. Between 1990 and 1992, the participants took three tests that measured memory and thinking skills. They took the same tests six years later, and again between 2011 and 2013. Their blood pressure was also measured, and researchers noted which participants were taking medicine to control high blood pressure (also known as hypertension).

There was a general decline over 20 years in memory and thinking skills (collectively called cognitive function). But high blood pressure in middle age was clearly linked with an increased risk of loss of memory and thinking skills:

-- The decline among participants with high blood pressure was 6.5% greater than in those with normal blood pressure.

--The decline among those with high blood pressure was more pronounced in whites than in African-Americans. However, because African-Americans had a higher death rate before the last set of tests, the researchers believe that their proportionately small number remaining may have skewed the results.

-- Among participants with high blood pressure in middle age, those who were taking medication to control it lost less cognitive ground over time than those with untreated high blood pressure.

-- Those who had normal blood pressure in midlife and who developed high blood pressure in their late 60s, 70s, and 80s had similar test scores as those who had normal blood pressure throughout.