Wider use of pills for blood pressure ‘can cut dementia’

HUNDREDS of thousands of people could be saved from dementia if blood pressure tablets were used more widely, a major study suggests.

Researchers have shown for the first time that aggressively treating high blood pressure – particularly in middle age – could also significantly reduce the risk of dementia later on.

NHS officials are under growing pressure to lower the threshold at which people can be given the drugs, a policy that could make 14million eligible for treatment.

Patients are currently considered to have hypertension – or high blood pressure – only if they have a reading of more than 140/90 mm Hg.

But a study of 9,400 people in the US found cutting the systolic threshold – the higher reading – to 120 instead of 140 slowed cognitive decline.

An ideal blood pressure reading is between 90/60 millimetres of mercury (mm Hg) and 120/80. The first figure is the systolic pressure, the ‘surge’ that occurs with each heartbeat. The second is the diastolic reading, which measures the pressure in the ‘rest’ between heartbeats.

Using the new threshold over eight years reduced rates of dementia and mild cognitive impairment by 15 per cent, according to results presented yesterday at the Alzheimer’s Association International Conference in Chicago. Similar trials have shown cutting the threshold for treatment would reduce the risk of heart disease by a fifth and strokes by about a quarter.

The NHS watchdog, the National Institute for Health and Care Excellence, is already reviewing blood pressure guidelines with a view to cutting rates of heart disease and a decision is expected next year.

But they will now face greater pressure to change the rules after the new research, the first to look in detail at the impact of such a policy on dementia.

Study leader Professor Jeff Williamson, of the Wake Forest School of Medicine in North Carolina, said: ‘These results support the need to maintain well-controlled blood pressure, especially for persons over 50.’

A second study of 670 patients by the University of Pennsylvania found that the lower threshold also slowed shrinkage of white brain matter, strengthening the link between blood pressure and dementia.

The US has led the way on blood pressure policy, lowering the treatment threshold in November from a systolic score of 140 to 130.

If the UK followed suit, it would mean an estimated 14million people – a third of all adults – would be eligible. Currently seven million are eligible.

A policy to increase this, however, would be controversial as it would affect many people who until now have been considered healthy. A similar change that lowered the threshold for cho- lesterol-busting statin drugs in 2014 led to a huge backlash, fuelling accusations that health professionals were ‘over-medicalising’ the middle aged.

Carol Routledge, of Alzheimer’s Research UK, said: ‘This study suggests treating high blood pressure intensively… may help to reduce the risk of memory and thinking problems.

‘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.’

But Professor Clive Ballard, of

‘Good for the brain’

Exeter University, warned: ‘All anti-hypertensives come with some risk of adverse effects, most seriously for kidney function.’

Those who feel light-headed when standing up after a long time sitting may be at greater risk of dementia and stroke, according to a US study of more than 11,000 people.

Scientists at Johns Hopkins University found those whose blood pressure dropped when they stood up – a problem known as orthostatic hypotension – had twice the risk of suffering a stroke in later life. Their risk of dementia was 54 per cent higher.