High blood pressure in your 30s is associated with poorer brain health

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(SACRAMENTO, Calif.) – Having high blood pressure in your 30s is associated with worse brain health around age 75, especially for men, according to a new UC Davis study.

The research, published this week in The Open JAMA Networkcompared magnetic resonance imaging (MRI) brain scans of older adults who had high blood pressure between the ages of 30 and 40 with those of older adults who had normal blood pressure.

The researchers found that the high blood pressure group had significantly lower regional brain volumes and poorer white matter integrity. Both of these factors are associated with dementia.

The study also showed that negative brain changes in some areas – such as decreased gray matter volume and frontal cortex volume – were stronger in men. They noted the difference may be related to the protective benefits of estrogen before menopause.

“Treatment for dementia is very limited, so identifying modifiable risks and protective factors over the course of life is key to reducing the disease burden,” said first author Kristen M. George, assistant professor in the Department of Public Health Sciences.

“High blood pressure is a very common and treatable risk factor associated with dementia. This study shows that hypertension status in early adulthood is important for brain health decades later,” said George.

High blood pressure is prevalent in the US

High blood pressure, also known as hypertension, is blood pressure that is higher than normal. Normal blood pressure level is less than 130/80 mmHg. The Centers for Disease Control and Prevention estimates that 47% of adults in the United States have hypertension.

High blood pressure levels vary by gender and race. About 50% of men have high blood pressure compared to 44% of women. The rate of hypertension is approximately 56% in black adults, 48% in white adults, 46% in Asian adults and 39% in Hispanic adults. African Americans ages 35 to 64 are 50% more likely to have high blood pressure than whites.

Data from healthy aging studies

The researchers looked at data from 427 participants from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) and Study of Healthy Aging in African Americans (STAR) studies. This gave them health data from 1964 to 1985 for a diverse group of Asian, Black, Latino, and white adults.

They obtained two blood pressure readings from when the participants were between the ages of 30 and 40. This allows them to determine whether they have hypertension, transition to hypertension, or have normal blood pressure in young adulthood.

MRI scans of the participants performed between 2017 and 2022 allowed them to search for the ultimate neuroimaging biomarkers of neurodegeneration and white matter integrity.

Significant reductions in cerebral gray matter volume were seen in men and women with hypertension but were stronger in men.

Brain scans reveal differences

Compared with participants with normal blood pressure, brain scans of those who transitioned to high blood pressure or with high blood pressure showed lower cerebral gray matter volume, frontal cortex volume, and fractional anisotropy (a measure of brain connectivity). Scores for men with high blood pressure were lower than for women.

This study joins growing evidence that cardiovascular risk factors in young adults impair brain health in later life.

The researchers note that because of sample size, they cannot examine racial and ethnic differences and recommend interpreting the results regarding sex differences with caution. They also noted that MRI data were only available from a single point in time in advanced age. It can only determine physical properties such as volumetric differences, not specific evidence of neurodegeneration over time.

“This study really shows the importance of early life risk factors, and to age well, you need to take care of yourself throughout life – heart health is brain health,” said Rachel Whitmer, the study’s senior author. Whitmer is a professor in the department of Public Health Sciences and Neurology and head of the Division of Epidemiology. He is also the associate director of the UC Davis Alzheimer’s Disease Center.

“We are excited to continue following these participants and uncover more about what people can do early in life to prepare for healthy brain aging later in life,” Whitmer said.

Additional authors of this study include Pauline Maillard, Evan Fletcher, Dan M. Mungas and Charles DeCarli, UC Davis; Paola Gilsanz, Kaiser Permanente Research Division; Rachel L. Peterson, University of Montana, Missoula; Joseph Fong and Elizabeth Rose Mayeda of UCLA; L. Barnes of Rush Medical College; M. Maria Glymour of UCSF.