Early hypertension associated with an increased risk of dementia

When diagnosed in adulthood or mid-life, hypertension was associated with smaller brain volumes and an increased risk of dementia, reported researchers in Hypertension.

The same was not true for hypertension diagnosed at the end of life.

Xianwen Shang, PhD, MPH, Researcher at Guangdong Provincial People’s Hospital, China, and his colleagues evaluated data from UK Biobank participants collected from 2006 to 2010. Researchers performed two analyzes including 11,399 participants with hypertension and 11,399 matched controls (age mean, 66 years; 42% female) for brain volume analysis and 124,053 participants with hypertension and 124,053 matched controls (mean age, 60 years; 47% female) for dementia analysis.

Researchers used brain MRI to measure brain volumes from 2014 to 2019, and dementia data was obtained from inpatient, mortality, and self-report data through 2021.

In multivariate analysis, a smaller total brain volume was observed in people diagnosed with hypertension under 35 years of age (beta = –10.83; 95% CI, –19.27 to –2.39), aged 35 to 44 (beta = –6.82; 95% CI, –12.18 to –1.46) and aged 45 to 54 (beta = –3.77; 95% CI, –6.91 to –0.64) compared to their respective controls. Hypertension was also independently associated with smaller gray matter volumes, peripheral cortical gray matter, and white matter when diagnosed in early and midlife.

In a median follow-up of 11.9 years, there were 4,626 cases of incident all-cause dementia. After adjusting for covariates, only people diagnosed with hypertension aged 35 to 44 had an increased risk of all-cause dementia compared to controls (HR = 1.61; 95% CI: 1.31-1.99).

Additionally, a diagnosis of hypertension in early adulthood or midlife was associated with smaller brain volumes and an increased risk of dementia, but not a diagnosis of hypertension later in life.

“The results of our study provide evidence to suggest that an early age of onset of hypertension is associated with the onset of dementia and, more importantly, this association is supported by structural changes in brain volume,” Shang said in a related press release. “Future research with brain volumes measured at multiple time points could confirm whether hypertension diagnosed at a younger age is associated with a greater decrease in brain volume over time.”