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A new study finds an association between hypertension at a young age and brain changes later in life. Tanutkorn Serapan/EyeEm/Getty Images
  • New research identifies brain changes in middle-aged people who have had high blood pressure since young adulthood.
  • Although the scope of the study does not tie the changes in the brain directly to cognitive deficits, there is reason to suspect that a connection exists.
  • The authors suggest that doctors should help young adults work aggressively to get hypertension under control as early as possible.

According to the Centers for Disease Control and Prevention (CDC), 47% of adults in the United States have high blood pressure, or hypertension.

Even though uncontrolled high blood pressure can damage organs, including the heart, and lead to stroke, just 1 in 4 adults in the U.S. with hypertension have it under control.

New study findings, which researchers presented at the American Heart Association’s (AHA’s) International Stroke Conference 2022, have revealed that long-term, uncontrolled hypertension has an additional effect.

The research shows that having hypertension since young adulthood results in changes to the brain by the age of 55 that may lead to cognitive problems.

The AHA’s threshold for a diagnosis of hypertension is a systolic blood pressure reading of 130 millimeters of mercury (mm Hg) or higher and a diastolic value of 80 mm Hg or higher.

The lead author of the study is Dr. Christina Lineback from the Department of Neurology at Northwestern Memorial Hospital in Chicago.

The study analyzed the medical records of 142 adults, which the team accessed from the National Institutes of Health’s (NIH’s) Coronary Artery Risk Development in Young Adults (CARDIA) study.

Overall, the study tracked more than 5,000 Black and white adults who were aged 18–30 years at the start of the project in 1985–1986.

Dr. Lineback told Medical News Today, “Our study included participants starting in their 20s and followed over 30 years into their 50s (average age at follow-up being 53); teenagers were not included.”

Speaking with the AHA Newsroom, Dr. Lineback says, “We were surprised that we could see brain changes in even this small sample of participants from the CARDIA study.”

The researchers found equal changes to the brain across all racial and ethnic groups.

Said Dr. Lineback to MNT:

“Our observations should encourage clinicians to be more aggressive in addressing blood pressure control — a modifiable risk factor — in young minority populations as a potential target to narrow disparities in brain health outcomes.”

“The changes in the brain structure that we noted on MRI,” Dr. Lineback told MNT, “were related to changes in the size of specific areas of the brain.”

“These areas,” said Dr. Lineback, “are important for many functions, including thinking, emotions, and moving.”

Dr. Larry B. Goldstein from the University of Kentucky in Lexington, who was not involved in the research, explained to MNT:

“The study reported lower brain volumes in older adulthood in those with higher blood pressures as young adults. Other studies find that high blood pressure is associated with injury to the brain’s white matter and deeper structures, generally related to blood vessel changes. Although not reported in this study, such changes can affect cognition (memory, processing, etc.).”

Dr. Goldstein stressed the importance of age and sex as risk factors:

“The risk [of hypertension] increases with age and is higher in men than women. In the 20–34 age group, 29% of men and 14% of women have hypertension [in the U.S.]. For men and women 35–44 [years old], the prevalence is 48% and 30%; 45–54 [years old] — 59% and 51%. Hypertension is quite common in U.S. young adults.”

“There is emerging evidence,” noted Dr. Lineback, “that vascular disease may begin to affect the brain in young adulthood and be exacerbated by social, economic, and racial inequalities.”

She explains, “Given the greater likelihood of high blood pressure in some racial and ethnic groups, this study’s finding should encourage healthcare professionals to aggressively address high blood pressure in young adults, as a potential target to narrow disparities in brain health.”