High blood pressure may lead to brain lesions

Unstable blood pressure may lead to white matter lesions in the brain that are associated with stroke and dementia.Researchers from the Erasmus Medical Center in Rotterdam, Netherlands, assessed the data on 1625 subjects who were participating in nine ongoing European studies and were 65 to 75 years old. Information about their blood pressure had been collected for 5 to 20 years.The team performed MRI brain scans to look for lesions in the area around the ventricular spaces and in the subcortex, and these were classified as severe or not severe.Compared with stable blood pressure levels over time, both decreases and increases in diastolic blood pressure, doubled risk of severe periventricular white matter lesions. Increase in systolic blood pressure was associated with a higher prevalence of severe periventricular and subcortical white matter lesions.Most severe lesions were associated with treated but uncontrolled high blood pressure. When the condition was either untreated or successfully controlled with treatment, the risk of brain lesions was comparable.Long-standing high blood pressure may cause structural changes in the small blood vessels, leading to low perfusion of the brain.The finding suggests that aggressive treatment may lead to precipitous drops in blood pressure, which may in turn cause low perfusion in areas that are already marginal.The results may offer potential therapeutic possibilities in preventing and reducing the attendant cognitive decline and dementia, but potential adverse effects of lowering blood pressure too much should also be considered.As per the pros and cons of different blood pressure-lowering drugs in terms of preventing dementia, there's some evidence that calcium channel blockers have a particular benefit.Clinical trials are needed to specifically address the question of whether blood pressure-lowering with or without calcium channel blockade can prevent Alzheimer's disease.