UK Edition
New blood pressure targets could cut dementia risk
New blood pressure targets should be introduced to cut the risk of dementia, research suggests.
Currently, around seven million Britons whose blood pressure exceeds 140/90 mm Hg are recommended to take daily medication.
NHS watchdogs are considering whether this threshold is low enough, with a number of studies suggesting that even lower levels are needed to protect against the risk of heart attacks and strokes.
Now a new study suggests that cutting the threshold could also significantly cut the risk of dementia.
Research on almost 10,000 adults found that when the systolic threshold was cut from 140 to 120 mmHG, the chance of dementia or other memory problems fell by 15 per cent.
The US trial was so successful in cutting heart disease risks that it was stopped after five years so that all patients could be offered treatment in line with the more ambitious targets.
But researchers from Wake Forest School of Medicine continued to track dementia risks for a further three years, among participants, who had an average age of 68.
The findings, presented at the Alzheimer’s Association International Conference in Chicago, prompted calls for more intensive treatment of high blood pressure, to get more patients to optimal levels.
Carol Routledge, Director of Research at Alzheimer’s Research UK, said: “We know that high blood pressure is a risk factor for dementia, and that taking steps to control it can have a range of health benefits.
"This study suggests that treating high blood pressure intensively, so that it doesn’t just go below the point at which doctors diagnose hypertension but continues towards the ideal, healthy range, may help to reduce the risk of memory and thinking problems.”
She highlighted NHS advice that blood pressure should not be above 120/80mmHg and that people over 40 should have their blood pressure checked regularly.
Ms Routledge said: “There is robust evidence that what’s good for the heart is also good for the brain and maintaining good vascular health is one of the key things people can do to reduce their risk of dementia.
“As well as maintaining a healthy blood pressure, the best current evidence suggests that not smoking, only drinking in moderation, staying mentally and physically active, eating a balanced diet, and keeping cholesterol levels in check can all help to keep our brains healthy as we age.”
Last year the American Heart Association redefined high blood pressure, saying that disease should be treated sooner, when it reaches 130/80 mm Hg, not the previous limit of 140/90.
The National Institute for Health and Care Excellence (Nice) is now considering a number of studies which led to the change of stance.
Such recommendations could see up to half of adults recommended to take daily medication.
The drugs, which cost the NHS as little as 10 pence a day, are normally recommended for patients deemed to have a 20 per cent risk of heart disease or stroke within the decade.
Research by Oxford University found that every 10 mmHg reduction in systolic blood pressure cut the risk of stroke and heart failure by about one quarter.
Medication – which costs just pennies – includes ACE inhibitors, angiotensin-2 receptor blockers (ARBs), calcium channel blockers, diuretics and beta-blockers.
Most patients take at least two types of pills, but more aggressive targets are likely to increase the number of different drugs recommended.
In 2014, Nice controversially published advice which said anyone with a 10 per cent risk of developing heart disease in a decade should be offered statins, to guard against strokes and heart disease.
The threshold means 40 per cent of adults are eligible for the drugs, with prescribing rates the third highest of any country in the Organisation for Economic Co-operation and Development.