Anew study has revealed that hypertension during the age of 48 to 67 years may pose as a greater threat of cognitive decline and dementia as compared with individuals who had normal blood pressure. The decline in global cognitive scores for participants with hypertension was 6.5 percent greater than for individuals with normal blood pressure.

An average ARIC participant with normal blood pressure at baseline had a decline of 0.840 global cognitive z score points during the 20- year period compared with 0.880 points for participants with prehypertension and 0.896 points for patients with hypertension.

Individuals with high blood pressure who used medication had less cognitive decline during the 20 period than participants with high blood pressure who were untreated. A greater decline in global cognition scores also was associated with higher midlife blood pressure in white participants than in African Americans. Although it was noted that a relatively modest additional (cognitive) decline associated with hypertension, lower cognitive performance increases the risk for future dementia, and a shift in the distribution of cognitive scores, even to this degree, was enough to increase the public health burden of hypertension and prehypertension significantly.

Initiating treatment in late life might be too late to prevent this important shift. Epidemiological data, including their own study, supported midlife BP as a more important predictor of and possibly target for prevention of late-life cognitive function than was later-life BP.