Updated on May 3, 2023.
Midlife brings about many physical changes—some are pretty harmless (those gray hairs popping up), while others are more serious. But one of the most common conditions that may develop in your 40s, 50s, and beyond is hypertension, or high blood pressure, which is affected by diet and activity levels, among other factors. Approximately half of US adults have hypertension, and many either don’t have it under control or aren’t aware they have it all.
And while hypertension is a risk factor for a range of health conditions, including heart attack, stroke, and diabetes, research has found that women who develop it before menopause may have a higher risk for dementia, as well.
Connecting midlife hypertension to dementia in women
Although researchers have known for a while that hypertension is linked to dementia, a study published in the journal Neurology sheds light on one specific population. In the observational study, participants were followed from their mid-30s to their 70s and 80s. Researchers analyzed health records, including blood pressure measurements, of these people when they were in their 30s and 40s. They then followed up to see who developed dementia.
Researchers found that women—but not men—who had high blood pressure in their 40s were more likely to have dementia later in life. In fact, women who developed hypertension in midlife had a 73 percent higher risk of dementia compared to women whose blood pressure remained normal.
Untangling the study’s results
The connection between hypertension and dementia in women may have something to do with female hormones, experts explain.
“In general, women as a group tend to be relatively hormonally protected from vascular disease and specifically from hypertension," says Sam Aznaurov, MD, a cardiologist at Presbyterian/St Luke's Medical Center in Denver, Colorado. As a result, he adds, women often develop hypertension later in life than men do.
That means women who have hypertension before menopause—when they’re supposed to be hormonally protected—may have more blood vessel damage. It’s theorized this could place them at increased risk for many other health issues, including dementia, since those vessels do the crucial job of supplying the brain with oxygen.
What you should know
Though these results are certainly intriguing, they don’t necessarily mean that those who have midlife hypertension are on track to develop dementia. And keep in mind that there is plenty you can do to lower your risk.
Since the Neurology study was observational, meaning health characteristics of a group were collected in a real world setting over time and later analyzed, it can’t be known for certain that hypertension causes dementia in this population. Some other issues to consider:
The study was relatively small. Although more than 5,000 people were included at the beginning, a little more than half were included in the follow-up. Research began in the 1960s, and hypertension treatment has advanced greatly since then. Therefore, the results may not be directly applicable to women who are in their 40s today.
Since more men than women died within the follow-up period, it is possible that they could have been diagnosed with dementia if they had lived longer; this means the results could have been skewed to show an effect for women but not men.
“If a woman in her 40s is reading this and saying, ‘Oh gosh, I have hypertension, that means I’m going to [get] dementia,’ that doesn’t necessarily mean that is going to be the case,” says Aznaurov. “We have a wealth of data that shows that treatment of hypertension does reduce the risk of vascular disease.” In fact, this study suggested that women who treated their high blood pressure had no greater chances of developing dementia.
Lifestyle changes that can lower hypertension include eating a well-balanced and low-sodium diet, limiting the use of alcohol, exercising regularly and maintaining a healthy weight. There are also medical treatments to manage hypertension. Talk to your healthcare provider to make sure you have the best plan for managing your condition.
Ultimately, more research is needed to explore the link between hypertension and dementia in middle-aged women—but it doesn’t hurt to adopt a heart-healthy lifestyle in the meantime.
