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Sep 09, 2015

Blood Pressure and Cognitive Function in Elderly Adults

Stopping blood pressure medication has little effect on brain function in elderly adults, says study.

Despite evidence linking low blood pressure to cognitive decline in the elderly, discontinuing blood pressure medication failed to improve brain function in older adults, according to a study published in JAMA Internal Medicine.

In most cases, high blood pressure is a dangerous condition that increases risk of serious complications. Not only does high blood pressure increase risk for heart attack and stroke, it can have a negative impact on brain function. However, many studies suggest that the opposite may be true in elderly adults.

Research suggests that having a low blood pressure actually increases risk for cognitive decline in adults over 75. The reason is simple. Later in life, it’s likely that a higher blood pressure is necessary to pump enough blood to the brain and other parts of the body. Therefore, experts wondered whether taking elderly adults off blood pressure medication may help prevent cognitive decline associated with low blood pressure levels.

To learn more, researchers analyzed data from the DANTE study (Discontinuation of Antihypertensive Treatment in Elderly People), conducted at 128 locations in the Netherlands. A total of 385 adults over 75 participated in the study, all of whom were on blood pressure medication but had their levels under control. Participants also had some signs of cognitive decline, such as trouble with memory or daily functions.

During the four-month study, half of participants were randomly chosen to stop taking blood pressure medication, while the other continued their usual regimen. Not surprisingly, those discontinuing their medication had significant increases in blood pressure levels, although this did not translate into greater risk of complications. There was no difference in brain function among either group after the study period.

Although low blood pressure is associated with poor brain function in the elderly, findings suggest that stopping blood pressure medication is not the key to preventing cognitive decline in older adults.

However, additional research is needed to better understand the relationship between blood pressure and brain function in the elderly. The DANTE study followed participants for 16 weeks, which may not have been long enough to detect changes in factors like memory and quality of life. Through larger studies that follow patients for a longer period of time, it’s possible that researchers may find a more meaningful association between changes in blood pressure and brain function in the elderly.

Questions for You to Consider

  • Who is at risk for high blood pressure?
  • Risk for hypertension increases with age, and most adults will eventually be affected by this condition at some time in their lives. However, diabetes, obesity, stress, high sodium intake, tobacco use and excessive alcohol use can greatly increase risk for high blood pressure.
  • How can I reduce my risk for hypertension?

  • There are a variety of ways to reduce risk for hypertension, such as eating a heart-healthy diet, exercising regularly, quitting smoking (if you smoke), limiting sodium intake, reducing stress and maintaining a healthy weight. For those already diagnosed with hypertension, these lifestyle changes can also be effective in treating and controlling the condition, sometimes in conjunction with certain blood pressure medications.

Featured Video

Hypertension is another way to say "high blood pressure." A patient has hypertension if their readings are above 140 over 90. With medication, the right diet, and a few lifestyle changes, however, hypertension can be managed.

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