Does treating high blood pressure improve brain health?

in collaboration with

Dr Christophe de Jaeger (Longevity and geriatrics)

According to the researchers, treating hypertension would be a way to improve certain brain lesions, observed on MRI.

Hypertension: standard treatment vs intensive treatment

The scientists based themselves on the MRI analysis of 658 volunteers, followed for this work for 4 years, on average. These participants, whose average age is 67, are 60% women, with no history of diabetes, dementia or stroke. In contrast, all participants suffered from high blood pressure.

Scientists have divided them into two groups:

• A group of 243 people, who received intensive treatment for high blood pressure with a systolic pressure target of 120 mm Hg.
• Another group of 199 people with standard treatment and a goal of 140 mm Hg.

A study on the observation of perivascular spaces

The scientists were interested in the perivascular spaces of the brains of the participants. “Perivascular spaces are spaces filled with cerebrospinal fluid, also called spaces of Virchow-Robin, located in the innermost layer of the brain“says Dr. Sandra Narayanan, a vascular neurologist and neuro-interventional surgeon at the Pacific Stroke & Neurovascular Center at the Pacific Neuroscience Institute in California.”They can enlarge with aging, inflammation, demyelinating disorders or neurodegenerative processes. They help remove water and metabolic waste from the brain“.

At the start of the study, the volume of the perivascular spaces was similar in the two groups. However, after almost four years of treatment for hypertension, the volume of the perivascular areas decreased significantly in the intensive treatment group. It did not change in the standard treatment group.

Focus on intensive treatment of high blood pressure

According to the researchers’ conclusions, intensive treatment of high blood pressure was more effective in improving or reversing damage in the perivascular regions of the brain than more moderate treatment.

The results of this study therefore suggest that the perivascular zones are dynamic and that it may be possible to reduce them with an intensive lowering of blood pressure. “This may be associated with better elimination of toxins in the brain and better brain health and help reverse the effects of high blood pressure on the perivascular space.” reported the researchers. “The positive side of this study corresponds to what we observe in the clinic: namely that the lesions and disorders can regress under treatment.“says Dr. de Jaeger.

What is the ideal blood pressure goal?

According to this study, therefore, monitoring and managing blood pressure is essential for a healthy brain.

But what is the objective to be maintained over time, with regard to blood pressure? “For me, the ideal blood pressure figures are 120/70 mmHg” first defines Dr. Christophe de Jaeger, physiologist and member of the committee of experts of Doctissimo. “But it is a difficult measure to establish, because blood pressure varies according to many parameters. The real evaluation of the blood pressure load is therefore a real problem for us doctors. It can be a major health problem, especially if combined with other risk factors, such as smoking or cholesterol.”.

To get a good idea of ​​your blood pressure, you need to have a good reliable measuring device, and take measurements throughout the day for several days. “You need a device with a cuff that is worn on the arm for the measurement. And perform the first measurement in bed, ie have the device close at hand on the bedside. Then redo different measurements during the day, before and after lunch, around 5 p.m. and in the evening, before going to bed“advises the doctor.

“And it is important to note the number of systolic pressure, diastolic, heart rate and its feeling: tired, angry, in good shape…”. The device should also be checked once a year at the attending physician’s office, in order to check whether the voltage readings are correct. “Then, on medical discussion, a Holter can be worn over 24 hours, for measurements during this period, or even the initiation of treatment” concludes Christophe de Jaeger.