Rising Blood Pressure Levels During Youth May Be Linked to Poor Brain Health Later in Life

Fact checked on April 19, 2022 by Rich Scherr, a journalist and fact-checker with more than three decades of experience.

Young people who have moderate to high blood pressure that gradually rises over time may be at risk for poor brain health later in life, researchers found.

The study, recently published in JAMA Network Open, shows that elevated blood pressure levels in youth that increase during early adulthood may impact the structure of the brain and exacerbate declining brain health later in life. The findings show how important it is to control blood pressure through your lifetime—including beginning at a younger age.

"We tend to think of ourselves as immortal when we are in our 20s, but what we do during that time frame matters" Pamela J. Schreiner, PhD, study co-author and professor in the Division of Epidemiology and Community Health at the University of Minnesota, told Health.

The main finding of the study, which involved brain magnetic resonance imaging (MRI) analysis of 853 participants, was that, compared with individuals who have more stable blood pressure trajectories from young adulthood through middle age, those who experience moderate to elevated blood pressure increases were more likely to have indications of poor brain health. This change in brain health included lower total gray matter volume, abnormal white matter volume, and lower gray matter blood flow.

Here's a closer look at what those findings mean and how to respond.

What the Research Shows

The study used data from Coronary Artery Risk Development in Young Adults (CARDIA), a prospective longitudinal study of Black and white men and women aged 18 to 30 years old. Participants were examined as many as eight times over a 30-year period—from 1985 through 2016. Participants also underwent MRIs during the study's 25th or 30th year, which were used to examine changes in both the brain's structure and its blood flow.

Researchers found that participants who had a higher blood pressure level at the start and experienced a gradual increase in blood pressure during early adulthood were more likely to have reduced brain health in midlife. The report added that "preventing blood pressure increases as early as young adulthood may be warranted."

Schreiner, the study lead, said the results suggest that identifying early risk factors and regularly monitoring blood pressure are critical because high blood pressure will not go away without intervention, and could lead to potential damage in the future.

Factors That Contribute to High Blood Pressure

Many people are unaware that they have elevated blood pressure because hypertension is usually asymptomatic, meaning there are no overt symptoms until it gets to a critical level, and the patient has a clinical event such as a heart attack or stroke, said Schreiner.

Common risk factors that can lead to hypertension, according to the CDC, include:

• High sodium or low potassium diet
• Lack of physical activity
• Obesity
• Too much alcohol
• Tobacco use
• Genetics and family history

Young people are particularly vulnerable because they might be less likely to monitor their blood pressure on a regular basis, according to Wanpen Vongpatanasin, MD, a hypertension specialist and cardiologist at UT Southwestern Medical Center in Dallas, Texas.

Certain groups of people, however, are more likely to have high blood pressure than others, according to the CDC. For instance:

• Men are more likely to have high blood pressure than women–50% of men versus 44% of women have this condition.
• High blood pressure is also more common in non-Hispanic Black adults—56% of non-Hispanic Black adults have high blood pressure, compared to 48% of non-Hispanic white adults, 46% of non-Hispanic Asian adults, and 39% of Hispanic adults.

How to Lower Blood Pressure for Future Brain Health

For those living with hypertension, there are proactive steps that can lower blood pressure—and doing so may help protect brain health later in life. Given that lifestyle plays a major role in hypertension, you might be able to successfully manage your blood pressure just by making healthy changes in your daily routine and modifying behavioral risk factors.

Schreiner stressed the power of prevention and said you have the ability to change potentially bad outcomes with minor adjustments. "Be mindful that what happens in your twenties does matter," Schreiner said. "The time for prevention is when you're young (age 18 to 30), not in your 50s, because by then you've missed a critical period to avoid cumulative damage. You can't control genetics, but a healthy lifestyle early on goes a long way to assuring you will have a healthy middle age."

Diet and Lifestyle Modifications

Even small modifications in your diet and lifestyle adjustments can make a difference. Both weight loss and lowering dietary sodium intake can improve blood pressure control, Jonathan Graff-Radford, MD, an associate professor of neurology at the Mayo Clinic in Rochester, Minnesota, told Health.

Engaging in regular physical exercise, eating a heart-healthy diet such as the Mediterranean diet, and limiting alcohol consumption are some of the steps suggested by Dr. Graff-Radford.

Treating other vascular risk factors, including diabetes, smoking, and obesity, are also associated with improved brain health, Dr. Graff-Radford said. Additionally, an emerging risk factor for dementia is hearing loss, so treating that may be an important consideration, as well.

Regular Blood Pressure Checks and Home Monitoring

Another step to consider is getting into the habit of monitoring your blood pressure much earlier in life, said Dr. Vongpatanasin, in order to ensure it stays at an optimal level over time. Dr. Vongpatanasin also recommends that all adults have at least a yearly screening and have blood pressure checked more often as they age.

"Many people make the mistake of waiting until they are much older to start thinking about their blood pressure, but in many cases, the damage may already be done by that point," Dr. Vongpatanasin cautioned.

Have your blood pressure checked on a regular basis by your primary care doctor, suggested Dr. Graff-Radford. "The monitoring frequency should increase if you're high risk or have a family history," he said.

While home monitoring (self-measured blood pressure) is not a substitute for regular doctor visits, the American Heart Association does recommend such self monitoring for individuals who have high blood pressure in order to assist their health care provider in determining whether treatments are successful. There are a variety of home monitor machines on the market, but be careful about which you select. Some give more accurate readings than others, said Dr. Vongpatanasin, who recommended visiting the website Validate BP (published by the American Medical Association) for a list of blood pressure devices that have been validated for clinical accuracy.

Medical Management

Left untreated, high blood pressure can be dangerous, so if lifestyle changes alone aren't correcting it, it may be time to control it through medical management, said Dr. Vongpatanasin.

"If you're at average risk and your blood pressure is consistently high and is not improving after six months of lifestyle changes, you need to seek the guidance of a physician," said Dr. Vongpatanasin, who added that most patients do well with medication, which is usually successful at stabilizing blood pressure.

Fortunately, there are effective treatments when it comes to addressing blood pressure challenges, including lifestyle adjustments and the blood pressure medications mentioned by Dr. Vongpatanasin. While not all causes of high blood pressure are in your control, there are still many ways to reduce your risk. And when measures are implemented early enough, they may even help maintain brain health over the long term.

"If it's identified that you have high blood pressure," said Dr. Graff-Radford, "It's empowering to know that by considering an earlier intervention and taking the necessary actions to treat it, you can potentially mitigate the negative effects in mid- and late life."