Meg Seymour, PhD, National Center for Health Research
High blood pressure (also called hypertension) can increase the risk of developing dementia as you get older.1,2 High blood pressure can narrow blood vessels in the brain, and those narrow blood vessels can burst or become blocked. This can prevent oxygen from getting to the brain. Brain cells can then become damaged or die, which can result in dementia.3
Two recent studies found that medications that lower blood pressure can help reduce the risk of dementia that would otherwise could be caused by high blood pressure.
A 2020 meta-analysis found that people with high blood pressure who take medication to lower their blood pressure are less likely to develop dementia or other signs of impaired thinking.4 A meta-analysis is a study that combines the results from several studies, in order to gather information about larger numbers of patients. This meta-analysis combined results from 12 studies with more than 92,000 patients who had high blood pressure. The patients in the 12 studies had been randomized to either get a treatment for high blood pressure or to a comparison group that was either given a placebo or a different dosage or drug combination. This type of study is considered the gold standard. After an average of 4 years, 7.0% of patients taking blood pressure medications developed dementia or cognitive impairment, compared to 7.5% of patients in the control groups. Although the difference seems small, it was statistically significant, which means it is unlikely to have occurred by chance. This means that if patients with high blood pressure lower their blood pressure with medications, they are slightly less likely to develop dementia or cognitive impairment. Despite the small difference, for every million people taking medication for their high blood pressure, this could mean 5,000 fewer people would develop dementia.
Another study published in 2020 had similar results.5 This was also a meta-analysis that combined the findings from 6 observational studies. Observational studies are not clinical trials, but instead gather information about people in the real world. This meta-analysis included more than 31,000 adults over the age of 55. It found that people with high blood pressure who took medication to lower their blood pressure were less likely to develop dementia than people with high blood pressure who did not. People with normal blood pressure who took blood pressure medications were not any less likely to have dementia, however. In other words, blood pressure medications only lowered the risk of dementia in people who had high blood pressure to begin with.
Some evidence has even suggested that certain types of blood pressure medications can help slow the progression of dementia in people with high blood pressure who have already been diagnosed with dementia.6
If you are concerned about your blood pressure, or about developing dementia, talk with your doctor about whether medications to lower your blood pressure might be a good option for you.
All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.
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- Whitmer RA, Sidney S, Selby J, Johnston SC, Yaffe K. Midlife cardiovascular risk factors and risk of dementia in late life. Neurology. 2005;64(2):277-281.
- Skoog I, Lernfelt B, Landahl S, et al. 15-year longitudinal study of blood pressure and dementia. Lancet. 1996;347(9009):1141‐1145. doi:10.1016/s0140-6736(96)90608-x
- Blood Pressure UK. Vascular dementia and high blood pressure. Bloodpressureuk.org. http://www.bloodpressureuk.org/BloodPressureandyou/Yourbody/Dementia.
- Hughes D, Judge C, Murphy R, et al. Association of Blood Pressure Lowering With Incident Dementia or Cognitive Impairment: A Systematic Review and Meta-analysis. JAMA. 2020; 323(19):1934–1944. doi:10.1001/jama.2020.4249
- Ding J, Davis-Plourde KL, Sedaghat S, Tully PJ, Wang W, Phillips C et al. Antihypertensive medications and risk for incident dementia and Alzheimer’s disease: a meta-analysis of individual participant data from prospective cohort studies. The Lancet Neurology. 2020; 19(1):61-70. https://doi.org/10.1016/S1474-4422(19)30393-X
- Shah K, Qureshi SU, Johnson M, Parikh N, Schulz PE, Kunik ME. Does use of antihypertensive drugs affect the incidence or progression of dementia? A systematic review. The American Journal of Geriatric Pharmacotherapy. 2009; 7(5):250-61.