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Blood Pressure Drop May Signal Dementia

Augusta Chronicle, The - July 09, 2004 A substantial drop in systolic blood pressure may be a warning signal for Alzheimer’s disease and dementia in some elderly people, according to a new study. Swedish scientists report today in Stroke, a journal of the American Heart Association, that a drop of 15 millimeters of mercury or more in the systolic reading of people 75 and older who started with systolic pressures of 160 or less was linked to a threefold increase in the risk of developing Alzheimer’s or other types of dementia. The same decrease of 15 points or more in the systolic (the top number in blood-pressure readings) level in patients who already had vascular problems such as stroke or diabetes increased the risk of Alzheimer’s by 2.4 times and the types of all dementia by 2.5 times. "Our findings imply that poor blood flow to the brain, resulting from an extensive decline in blood pressure, may promote the dementia process," said Dr. Chengxuan Qiu, an epidemiologist at the Karolinska Institute in Stockholm who was lead author of the study. But he cautioned that because so few studies have addressed the link between blood-pressure decline and dementia, the findings must be verified. "We have to consider that patients with dementia experience a decline in blood pressure for some years before diagnosis, which continues to decline after the onset of dementia," said Dr. Laura Fratiglioni, a professor at the institute who led the project. Earlier studies have shown that high blood pressure in middle age is associated with increased risk of dementia and Alzheimer’s later in life, but studies of older people have been conflicting. The Karolinska researchers themselves have suggested in the past that both high and low blood pressure may damage cognitive ability in the elderly. For the latest study, the researchers followed 947 people age 75 and older who had no evidence of dementia when they entered the project, and underwent physical exams including blood-pressure testing. This was repeated three and six years later. At the end of three years, 147 patients were diagnosed with Alzheimer’s and 39 with other dementia; at six years, the researchers found 91 more had Alzheimer’s and 27 more had other types of dementia. There was no difference in blood-pressure levels among the patients at the start, but those who experienced a systolic decline during the study were more likely to be among those diagnosed with dementia later.

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