Warning sign about brain health could be hiding in plain sight, researchers say

A new study from the University of Southern California suggests that the way blood pressure fluctuates from one heartbeat to the next may be as important as the overall blood pressure reading, especially when it comes to brain health in older adults.

The researchers found that older adults who experienced greater beat-to-beat changes in blood pressure had smaller brain volumes in areas related to memory and higher levels of a protein linked to nerve cell injury.

“Even when blood pressure is well controlled with medications, rapid fluctuation in blood pressure from beat to beat is associated with poorer memory and signs of brain shrinkage and brain cell injury,” USC professor Daniel Nation, lead author of the study, told News Digital.

“Blood pressure is not static; it always adapts to the body’s needs,” he added in a news release. “But as we age, that regulation can become less precise.”

The study included 105 adults between 55 and 89 years old. The researchers measured the participants’ blood pressure continuously for several minutes while they underwent brain scans.

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In particular, they measured the stiffness of the adults’ arteries and how much their blood pressure changed between heartbeats.

Even when participants’ average blood pressure appeared healthy, those with more erratic readings (combined with stiffer arteries) showed telltale signs of brain aging, the study found.

Specifically, they had smaller regions of the hippocampus and entorhinal cortex, which are among the first brain areas affected in Alzheimer’s disease. They also had higher blood levels of neurofilament lumen, a biomarker of nerve cell damage.

These findings were described as significant even after taking into account factors such as age, sex and average blood pressure, suggesting that the fluctuations themselves, and not just overall pressure, may be a key risk factor.

The findings were first published online in the Journal of Alzheimer’s Disease on October 17.

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For years, doctors have warned that high blood pressure increases the risk of dementia, but the USC study specifically explores how moment-to-moment instability may be a cause for concern.

Nation said researchers were surprised to find that these rapid fluctuations in blood pressure were related to brain injury, “regardless of whether they have hypertension or are treated with blood pressure-lowering medications.”

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In other words, someone could have “good” readings at the doctor’s office and still have dangerous spikes and dips that silently stress the brain’s delicate blood vessels, the research suggests. Over time, this instability could contribute to memory decline and neurodegeneration.

However, the researchers emphasized that this study only shows a correlation and does not prove causation, and that more research is needed.

“The findings are correlations in a cross-sectional study, which is like a snapshot in time,” Nation said. “Future studies should examine how these rapid blood pressure fluctuations change over time and whether they predict future brain shrinkage, brain cell injuries, and memory impairment.”

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The team says there are currently no specific treatments for these fluctuations.

“But it is still very important for people to monitor their blood pressure and take blood pressure-lowering medications as prescribed to reduce the risk of brain injury and memory impairment,” Nation said.

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“Developing therapies to address rapid blood pressure fluctuations should be a priority, as these rapid fluctuations are not fully addressed by existing treatments that focus on lowering average blood pressure,” he added.