Older adults often monitor their blood pressure as elevated levels could have serious consequences to their health. Younger individuals should also be conscientious of their blood pressure levels as hypertension in midlife could also lead to unwanted health conditions later in life. A new study has found that elevated blood pressure level in midlife is associated with mental decline in old age.

For the new study published in JAMA Neurology on Aug. 4, Rebecca Gottesman, from the Department of Neurology at the Johns Hopkins University School of Medicine in Baltimore, Maryland, and colleagues followed nearly 14,000 individuals between 48 to 67 years old for up to 23 years to assess the link between hypertension in middle age and change in cognitive performance 20 years later.

The researchers looked at the blood pressure levels of the participants at the start of the study and later tested their mental abilities three separate times. They found that the participants with hypertension had 6.5 percent reduction in brain power scores compared with those who had normal blood pressure.

The cognitive decline, however, was lesser in participants with high blood pressure but used medications for their condition. Gottesman and colleagues found that the subjects whose elevated blood pressure level was controlled with medication were less likely to experience mental decline later in life than the participants whose high blood pressure was not controlled. They also observed that the effect is stronger among white participants than blacks.

"Midlife hypertension and elevated midlife but not late-life systolic BP was associated with more cognitive decline during the 20 years of the study," the researchers wrote. "Greater decline is found with higher midlife BP in whites than in African Americans."

Gottesman said that while the difference is modest, a cognitive decline equivalent to making a person 2.7 years older mentally could lead to earlier onset of mental health problems such as Alzheimer's disease, the most prevalent form of dementia.

Philip Gorelick, from the Michigan State University College of Human Medicine who wrote an editorial that accompanied the study, said that midlife is the best time to do something about blood pressure levels as the brain is not yet subjected to the ill effects of increased blood pressure level that cause unwanted changes in the brain.

"Middle age may be an ideal time window to intervene on blood pressure as the brain has not yet received a long-term or chronic pounding from blood pressure elevation which can set the stage for irreversible brain changes that affect cognition," Gorelick said.

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