Rising Blood Pressure in Early Adulthood Tied to Poor Brain Health Later in Life

High blood pressure illustration.

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Key Takeaways

  • A new study suggests that young adults with moderate or high blood pressure that continues to increase over the years are at a higher risk for poor brain health later in life.
  • People with rising blood pressure were more likely to have issues with cognition and memory than those with low or stable blood pressure levels.
  • The results suggest ‌if left untreated, rising blood pressure could contribute to future neurological problems, including dementia.

Young adults with moderate or high blood pressure that continued to gradually increase as they reached middle age may have a higher risk for poor brain health, according to a new study published in JAMA Network Open.

The findings suggest that the trajectory of a person’s blood pressure levels matters. In other words, having high blood pressure at a young age that continues to worsen over time can significantly impact the structure of the brain.

Experts have known for some time now of a relationship between high blood pressure and brain health. Gabriel Zada, MD, a neurosurgeon and director of the USC Brain Tumor Center at Keck Medicine of USC (University of Southern California) who was not involved in the study, told Verywell blood pressure is linked to inflammatory issues and small injuries to blood vessels that could cause stroke and various forms of dementia.

In the current study, people with gradually increasing blood pressure showed abnormal changes to white matter in their brains. Without considering blood pressure medication, people with high blood pressure as young adults whose blood pressure gradually increased over time also showed lower blood flow to the gray matter areas in the brain.

White matter has million of axons used to send messages to other neurons in other brain regions. Disruptions in the white matter in the brain may eventually turn into a white matter disease—a neurological condition that causes memory loss and a person’s ability to think, communicate, and balance. Because of the cognitive decline, changes in white matter may contribute to dementia.

“What we’re getting out of this paper is that if you can find the people with moderate hypertension who are showing increased slopes or trajectories, if you can identify that sector and work to keep their blood pressures under control, it may show a reduction in a variety of conditions or brain changes,” Zada said.

How Blood Pressure Impacts the Brain

The research team analyzed the data of participants who enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study that looked at the heart health of White and Black adults.

Since the start of the study in 1985, over 5,000 participants (who were between 18 to 30 at the time) had their blood pressure checked and then rechecked eight more times within the next 30 years. 

There were 885 participants from the original cohort (now between 42 and 61 years old) who had their brains scanned using an MRI after 25 or 30 years. The research team used the brain images to study any changes in brain structure and cerebral blood flow.

Based on their blood pressure readings later in life, the team categorized the participants into five groups:

  • Low-stable group: people who had low blood pressure levels throughout the entire study
  • Moderate-gradual group: people who started out with moderate blood pressure levels and experienced gradual increases as they aged
  • Moderate-increasing group: people who started at moderate levels but experienced a sharp increase over time
  • Elevated-stable group: people who started and maintained high blood pressure throughout the study period
  • Elevated-increasing group: people who started out with high blood pressure that gradually increased until they hit 40, then experienced a moderate decrease 

Participants who had high blood pressure that gradually increased in middle-age showed the smallest amount of gray matter volume and the highest abnormal white matter volume compared to people who maintained low blood pressure levels.

The elevated-increasing group also had the lowest amount of blood flow to gray matter areas compared to all other groups. Although, after the researchers considered the use of blood pressure medication in their analysis, the decrease in gray matter cerebral blood flow became nonsignificant.

People that began with moderate blood pressure levels and gradually increased it over time had more abnormal white matter volume than people with continuously low blood pressure. 

A separate analysis showed that people in the moderate-increasing, elevated-increasing, and elevated-stable groups did worse on tests measuring their executive function and verbal memory. The results suggest that people with a trajectory of increasing blood pressure from young adulthood to middle-age experienced more cognitive impairments than those with low blood pressure or whose blood pressure levels remained stable throughout the years.

What This Means For You

If you suspect you're at risk for developing high blood pressure, get checked with a healthcare provider. There are certain lifestyle changes you can make to improve your blood pressure like exercising, eating a heart-healthy diet, and reducing alcohol.

How to Manage Your Blood Pressure 

Proactive is better than reactive healthcare. Zada emphasized the importance of getting your blood checked at least once a year by a healthcare provider. If you have close family members with high blood pressure, your risk of developing high blood pressure increases.

There are also blood pressure monitors you can buy at the local pharmacy that can give you a reading in minutes. A healthy blood pressure level is less than 120/80 mm Hg. Healthcare providers tend to diagnose patients with high blood pressure if they consistently measure at 130/80 mm Hg or higher.

Getting a high or moderately high blood pressure reading multiple times can help you determine if you need to see your provider sooner and get started on a treatment plan early.

Beyond genetics, how you live your life can contribute to rising high blood pressure over time. The good news is that you can start today to control your blood pressure with no medication. These include:

  • Lowering your stress levels
  • Drinking less alcohol
  • Reducing your salt intake
  • Eating a heart-healthy diet
  • Getting at least 2.5 hours of exercise a week
  • Maintaining a healthy weight
  • Sleeping at least 7 hours every night

“Maintaining a normal and healthy range of blood pressure is very critical even in the younger ages of life,” Zada said. “It’s important for people to be vigilant about that and maintain a relationship with their doctor to keep their blood pressure within a healthy range, whether it’s with lifestyle or medication choices.”

He added that making healthier choices such as exercising and not smoking has widespread effects on your health as they also help with reducing the risk of dementia.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Hu YH, Halstead MR, Bryan RN, et al. Association of early adulthood 25-year blood pressure trajectories with cerebral lesions and brain structure in midlife. JAMA Netw Open. 2022;5(3):e221175. doi:10.1001/jamanetworkopen.2022.1175

  2. Centers for Disease Control and Prevention. Know your risk for high blood pressure.

  3. Centers for Disease Control and Prevention. High blood pressure symptoms and causes.

  4. National Institute on Aging. High blood pressure and older adults.

By Jocelyn Solis-Moreira
Jocelyn Solis-Moreira is a journalist specializing in health and science news. She holds a Masters in Psychology concentrating on Behavioral Neuroscience.