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How the blood pressure is lowered affects the risk of Alzheimer's



Most people are familiar with the measures they can take to reduce their risk of heart disease and cancer. It has been shown that careful dieting, smoking and smoking reduce the risk of these diseases.

But when it comes to dementia – including dementia related to Alzheimer's disease – scientists have not found many actionable steps that people can take to reduce their risk. Genes play a prominent role in the development of dementia, especially Alzheimer's, and age is also a dominant factor in brain degenerative disease, but both are not under human control.

Now, in a presentation at the annual Alzheimer's Association meeting in Chicago, researchers report some of the most encouraging evidence of a risk factor that people can control to lower their dementia risk: their blood pressure. In an extension of the SPRINT study, which looked at how low blood pressure can prevent heart disease, scientists also found that lower blood pressure is associated with a lower risk of dementia.

In the SPRINT Memory and Cognition in Reduced Hypertension (SPRINT-MIND) study, more than 9,300 elderly people who had heart problems or had a higher risk of heart disease were randomized to lower their blood pressure to less than 1

20 mmHg or 140 mmHg systolic. (Current guidelines, revised in 2017 after the study began, now recommend that most people keep the upper number or systolic pressure below 130 mmHg.) People who have lowered their blood pressure to below 120 mmHg have lowered their risk for mild cognitive disorders (MCI). , the gateway to dementia, or likely dementia by 15%, compared to people who lowered their blood pressure to 140mmHg.

"Control of blood pressure is not only good for the heart but also good for the brain," says Dr. Jeff Williamson, head of geriatric medicine at the Wake Forest School of Medicine and one of the lead investigators in the study. "This is the first intervention of any kind that has been demonstrated in a randomized controlled trial to reduce the risk of mild cognitive impairment."

Williamson notes that the study does not confirm that lowering blood pressure can lower the risk of dementia, but this may be because dementia develops longer than MCI, and the study followed humans only for an average of five years – long enough to detect probable dementia, but not necessarily dementia, which may take longer. Nevertheless, it is the first time that scientists have found something that can lower MCI risk in a rigorous, randomized controlled trial, and that could help reduce the number of people in the coming decades could be affected by MCI and even dementia. "This is a great encouragement for people to say, yes, make sure your blood pressure is well controlled, because right now it's one of the things you can do to prevent mild cognitive impairment Door to test for further interventions. "

" That's a very big deal, "says Maria Carillo, Chief Science Officer of the Alzheimer's Association. "Now we have evidence that lowering blood pressure is also related to the health of the brain, previously it was strongly recommended, but now we know from a study that it can make a difference."

Study participants, such as the 74-year-old Margaret Daffodil Graham from North Carolina, are welcome relief results. Since she was diagnosed with high blood pressure in the thirties, Graham has been taking medication to control her blood pressure. She joined the study to make sure her blood pressure was monitored and kept under control, and she is sure that could keep her brain intact as well. "My thing is, do not think about it," she says. "Just let my mind be okay, I can handle my body failing, but without your mind there is nothing, so I do what I have to do to keep my body fit and hopefully not lose my mind.

As part of her regime to control her blood pressure, Graham takes long walks, makes her garden in the summer and makes regular trips to the local YMCA for weight training to maintain muscle strength.

For people like Graham, the study could make a difference in reducing their risk of developing dementia in the coming years. Williamson says the Alzheimer's field has been frustrated in recent years by disappointing studies of new drugs that physicians hoped would be the first to actually treat the disease and slow down or even reverse cranial nerve damage, memory loss, disorientation and other issues cause higher thinking skills. The possibility of lowering blood pressure, which people can control, could lower the risk of dementia and even Alzheimer's could be groundbreaking.

Another week Neurology published a study idea that controlling blood pressure may affect dementia. In this study, researchers at Rush Alzheimer's Disease Center found that people with higher blood pressure tended to have more brain lesions or areas of dead brain tissue that had lost their blood supply, as well as tangles of tau protein, a hallmark of Alzheimer's disease the researchers found when they performed autopsies on the participants.

These data, along with the latest experimental results, support the idea that keeping blood pressure may be a way that some people may experience brain worsening dementia and even Alzheimer's. "I want to illustrate the idea to my patients with the analogy of air pressure in our tires," says Williamson. "You do not want to push too low or too high, otherwise you'll damage the tires, and the same goes for blood pressure, and over time, high blood pressure can damage the walls of very delicate arteries that deliver blood to the brain and other organs can see some of the things we associate with dementia – inflammation and small strokes.

More research must be done to explore the connection, especially since the volunteers in the study all have a history of heart problems, it is It is not clear how generalizable the results are for people without other heart problems but who may have high blood pressure, but the results are an encouraging sign that people can finally do something to address their risk for brain, body and dementia. 19659017]
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