Blood pressure changes in mid-30s linked to poorer brain health

Written by Sharon Salt, Editor

A recent study led by researchers at University College London (UCL; UK) has indicated that changes in blood pressure in individuals as young as 36 could be linked to markers of poorer brain health.

The findings from the study, termed Insight 46, are published in The Lancet Neurology.

Insight 46 is a neuroscience sub-study of the Medical Research Council National Survey of Health and Development (NSHD), which is the longest running birth cohort in the UK. The study is designed to follow over 500 birth cohort members to determine early signs and risk factors for dementia as they reach their 70s.

Find out more about Insight 46 here:

Although blood pressure in midlife has been linked to a higher risk of dementia previously, the mechanism by which this happens, including the time when blood pressure is most important, remain uncertain.

In search for an answer to these questions, the researchers followed 502 individuals from the NSHD who all were born in the same week in 1946. At the start of the study, all participants were free from dementia and 465 underwent brain scans to assess their brain health. The researchers reported that they were able to measure the participants’ blood pressures at the following ages: 36, 43, 53, 60–64 and 69.

With the brain scans, the team were able to observe levels of amyloid present within the brains, as well as assess the size of the brain and presence of blood vessel damage.

Their results demonstrated that higher blood pressure at the age of 53 and quicker rises in blood pressure between 43 and 53 were associated with more signs of blood vessel damage, or ‘mini strokes’, in the brain when an individual was in their early 70s.

In addition to this, higher blood pressure at the age of 43 and greater increases in blood pressure between the ages of 36 and 43 were linked with smaller brain volumes.

The researchers reported that blood pressure was not associated with the amount of amyloid protein in the brain and did not appear to predict memory and thinking problems.

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“The Insight 46 study has allowed us to reveal more about the complex relationship between blood pressure and brain health. The findings suggest that blood pressure even in our 30s could have a knock-on effect on brain health four decades later,” explained study author Jonathan Schott (UCL Queen Square Institute of Neurology).

“We now know that damage caused by high blood pressure is unlikely to be driven through the hallmark Alzheimer’s protein amyloid, but through changes in blood vessels and the brain’s architecture. The findings show that blood pressure monitoring and interventions aimed at maximizing brain health later in life need to be targeted at least by early midlife,” Schott added.

The Insight 46 study will continue to monitor these participants in the years to come to explore whether those with worse brain health are more prone to cognitive decline and dementia.

Sources: Lane CA, Barnes J, Nicholas J et al. Associations between blood pressure across adulthood and late-life brain structure and pathology in the neuroscience substudy of the 1946 British birth cohort (Insight 46): an epidemiological study. Lancet Neurol. doi:10.1016/S1474-4422(19)30228-5 (2019) (Epub ahead of print);