A new JAMA study has shed light on a troubling issue: the vast majority of Americans with hypertension—nearly 120 million—don’t have their blood pressure under control, and most don’t even know they have the disease. The study revealed that 79% of individuals with hypertension had uncontrolled blood pressure, and nearly 58% were unaware of their condition altogether. These findings are alarming, as uncontrolled hypertension is a leading contributor to cardiovascular disease, cognitive decline, and chronic kidney disease.

But the implications for brain health may be the most concerning. Recent research underscores a critical link between hypertension and the increased risk of dementia. A landmark trial presented at the 2023 American Heart Association (AHA) Scientific Sessions demonstrated that intensive blood pressure management significantly reduces the risk of all-cause dementia by 15%. This reinforces what many in the field of neurology have long known: hypertension isn't just bad for the heart—it's harmful to the brain's delicate vasculature.

Blood pressure affects the brain in profound ways. Hypertension can damage the blood-brain barrier, increase the risk of small vessel disease, and reduce cerebral perfusion, all of which accelerate neurodegenerative processes. Elevated blood pressure, particularly when left unchecked, results in chronic damage to the brain’s small blood vessels, impairing their ability to supply oxygen and nutrients to critical brain regions, such as the hippocampus, the seat of memory.

Given the projected rise in dementia cases—expected to triple globally by 2050—the urgency of addressing hypertension as a modifiable risk factor cannot be overstated. Yet, the JAMA study highlights a failure in current care models, as nearly 70% of patients with uncontrolled hypertension had visited their healthcare provider twice or more in the previous year without receiving appropriate interventions.

The takeaway is clear: improving hypertension detection, control, and management must become a public health priority, not just for cardiovascular health but for cognitive longevity.

At BrainKey, we’re advancing this mission by offering personalized insights into brain health, including advanced imaging to monitor vascular integrity. By understanding the effects of hypertension on the brain, we aim to empower individuals and clinicians to take proactive steps toward preventing cognitive decline.

The future of brain health depends on controlling hypertension today.

Citations:

“Examining the Hypertension Control Cascade in Adults With Uncontrolled Hypertension in the US” -->

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2823542

“Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission” --> https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01296-0/abstract

JAMA: “Use of Antihypertensives, Blood Pressure, and Estimated Risk of Dementia in Late Life

An Individual Participant Data Meta-Analysis” --> https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2809194

“AMA Conference Paper: Lowering blood pressure significantly reduced dementia risk in people with hypertension” https://newsroom.heart.org/news/lowering-blood-pressure-significantly-reduced-dementia-risk-in-people-with-hypertension

For more information on the blood brain barrier see this review --> “The Blood-Brain Barrier: Composition, Properties, and Roles in Brain Health” https://lnkd.in/efZeeW5A