High Blood Pressure Can Adversely Affect Older Adults. Here’s How

High blood pressure can adversely affect older adults if not diagnosed on time. We speak to doctors to understand the effects of high blood pressure and the brain damage it could cause.

When 80-year-old Chandrika* was brought to a Bangalore-based hospital, she had a recurring stroke and memory loss. Hardly did anyone realise that her increasing blood pressure was responsible for the stroke and memory loss till she was diagnosed to have elevated home blood pressure with persistent morning spikes in blood pressure. Not just that, her nighttime blood pressure was found to be very high. Interestingly, her office blood pressure recordings taken at the doctor’s were just normal which is why her hypertension did not get detected earlier, resulting in stroke and memory loss.

DOCSPEAK: Vascular risk factors are associated with the risk of not only vascular dementia but also Alzheimer’s disease.

According to Dr Sanjay Bhat, Consultant – Interventional Cardiology at Aster CMI Hospital, Chandrika’s treating doctor, optimising blood pressure measurements and early diagnosis could have prevented the stroke and memory loss in her. “Uncontrolled high blood pressure can lead to stroke by damaging and weakening your brain’s blood vessels, causing them to narrow and rupture. High blood pressure can also cause blood clots to form in the arteries leading to your brain, blocking blood flow and potentially causing a stroke. High BP in middle age is a risk factor for dementia. To fully evaluate its impact, hypertension should be assessed several decades before the onset of dementia. Vascular risk factors are associated with the risk of not only vascular dementia but also Alzheimer’s disease,” says Dr Bhat.

Did you know that high blood pressure had a connection to the brain? An observational study recently published in The Lancet Neurology Journal reveals that high blood pressure may have an adverse impact on the brain among older adults. The study highlights that high blood pressure along with a considerable increase in blood pressure in midlife may be linked with brain pathologies in later life and may result in several disorders associated with the brain.

High blood pressure has already become a serious health concern among older adults in India and can result in a significant burden on the country’s healthcare, specifically the elderly care services in the days to come. Data recorded by the Indian Council of Medical Research (ICMR) shows that around 10.8 per cent of deaths in the country is due to high blood pressure or hypertension. Not just that, this data also indicates that hypertension happens to be one of the primary drivers behind the increasing rates of dementia in India.

Another study has revealed that the urban Indian population suffers more from hypertension compared to the rural Indian population. The percentage of the population suffering from high pressure has seen a rise from 23.0 per cent to 42.2 per cent in urban areas between 1991 to 1994 and 2010 to 2012. In rural areas, the percentage of increase was from 11.2 per cent to 28.9 per cent over the same time period.

DOCSPEAK: A person who has normal blood pressure at the age of 50 years has an 80 per cent lifetime risk of developing high blood pressure.

According to doctors, there is a noteworthy association between increased blood pressure and brain pathology. Dr Sreekanth B Shetty, Senior Consultant and Head, Interventional Cardiology, Sakra World Hospital, Bangalore, told Silver Talkies: “A person who has normal blood pressure at the age of 50 years has an 80 per cent lifetime risk of developing high blood pressure. High blood pressure is silent and often undiagnosed. Even when identified, it often remains inadequately treated, often due to misconceptions amongst doctors and patients alike. Untreated and inadequately treated blood pressure affects blood vessels everywhere in the body leading to heart diseases, stroke and other brain pathology, kidney failure, blindness and more.”

DOCSPEAK: High blood pressure is associated with a high incidence of ischemic and hemorrhagic strokes as has been proven by various studies. In fact, every 10mmHG rise increases the risk several-fold.

Speaking about how high blood pressure particularly affects the brain and results in cognitive decline among older adults, Dr Charu Goel Sachdeva, Consultant, Internal Medicines, Manipal Hospital, Dwarka, said: “High blood pressure is associated with several detrimental effects on the body particularly on the brain. Its association with the atherosclerotic process causes the vessels to narrow leading to poor blood supply to various parts of the brain. An essential vessel may get obliterated and lead to a complete blockage of blood supply. High blood pressure is associated with a high incidence of ischemic and hemorrhagic strokes as has been proven by various studies. In fact, every 10mmHG rise increases the risk several-fold.”

Several brain-related diseases can occur due to the adverse effect of high blood pressure. Here are some of them that you must be aware of.

Ischemic Stroke

This happens because of blockages in brain arteries. It manifests as the weakness of limb (paralysis), facial asymmetry, loss of sensations and more. The disability varies in severity depending on the amount of brain involved. If large arteries to the brain are affected, stroke can be life-threatening and severely disabling. Early detection of stroke and treatment is very important to limit the damage.

Cerebral Haemorrhage

This happens due to the rupture of blood vessels in the brain, usually in those with high blood pressure. This manifests as severe headache, limb paralysis, vomiting, altered consciousness, fits, etc., depending upon the extent and location of the bleed. Prompt recognition and treatment are obviously lifesaving.

Dementia and Vascular Parkinson’s Disease

Blood pressure also manifests less dramatically, but in an equally or more disabling manner by causing dementia. This is because of the slow degeneration of blood vessels in various forms with progressive damage to the brain tissue. This leads to memory loss and even Parkinson’s.

You can diagnose Brain disorders related to high blood pressure by Imaging modalities such as MRI, MR angiography, CT scan, Ct angiography, carotid ultrasound doppler. Immense advances have been made in the area of radiology which allows rapid recognition and treatment of stroke. Additionally, heart-related tests such as ECG, Echocardiography, Holter are needed to be done to complete the assessment.

It is essential to keep a check on rising blood pressure in order to keep both your brain and body healthy. Doctors suggest older adults go for a daily check-up to keep hypertension-related brain and body disorders in control.

*Name of patient changed on request