Research Highlights:

  • Younger adults (ages 20-40) with high blood pressure had brain changes by midlife (average age 55) that may increase their risk of cognitive decline later in life or over time.
  • These changes were similar across all races and ethnic groups examined in the study when accounting for the degree of high blood pressure exposure.
  • The findings suggest health care professionals consider more aggressive high blood pressure treatment for younger adults to prevent brain changes in later life.

Embargoed until 4 a.m. CT/5 a.m. ET Thursday, Feb. 3, 2022

NEW ORLEANS, Feb. 3, 2022 — High blood pressure among younger adults, ages 20-40 years, appears to be linked to brain changes in midlife (average age 55) that may increase risk for later cognitive decline, according to preliminary research to be presented at the American Stroke Association’s International Stroke Conference 2022, a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health to be held in person in New Orleans and virtually, Feb. 8-11, 2022.

According to the American Heart Association, from 2015-2019 more than 47% of U.S. adults had high blood pressure. In 2019, the U.S. age-adjusted death rate primarily attributable to high blood pressure was 25.1 per 100,000. High blood pressure death rates for non-Hispanic Black adults were 56 per 100,000 among males and 38.7 per 100,000 for females.

Studies have found that high blood pressure disrupts the structure and function of the brain’s blood vessels, damaging regions of the brain that are critical for cognitive function.

“There are studies to suggest changes to the brain may start at a young age,” said Christina Lineback, M.D., lead study author and a vascular neurology fellow at Northwestern Memorial Hospital in Chicago. “Our study provides further evidence that high blood pressure during young adulthood may contribute to changes in the brain later in life.”

Researchers analyzed 30 years of follow-up including MRI brain images (performed once at the age of 30, and then again at midlife - about the age of 55 years) for 142 adults from the Coronary Artery Risk Development in Young Adults (CARDIA) study. The CARDIA study enrolled participants from four U.S. cities (Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California), in 1985-1986. In total, the study recruited more than 5,000 Black and white adults, ages 18 to 30 years, who have been followed for over 30 years.

In one follow up including 142 of the participants (42% women), researchers examined changes in brain structures in midlife (average age 55) from cumulative exposures to vascular risk factors, including high blood pressure, cholesterol, body mass index, smoking and glucose, from young adulthood to midlife. They also evaluated if there were any differences by race or ethnicity; nearly 40% of the study participants (n=55) were Black adults.

The analysis found:

  • Younger adults who had higher cumulative blood pressure exposure (from 25 to 55 years of age) had more changes visible on brain imaging at midlife, which may increase the risk of cognitive dysfunction in mid- and late life.
  • The brain changes that occurred were similar across all races and ethnic groups examined in the study when accounting for the degree of high blood pressure exposure.

“We were surprised that we could see brain changes in even this small sample of participants from the CARDIA study,” Lineback said. “Given the greater likelihood of high blood pressure in some racial and ethnic groups, this study’s finding should encourage health care professionals to aggressively address high blood pressure in young adults, as a potential target to narrow disparities in brain health.”

A potential next step is to develop and implement systems to better treat and monitor blood pressure in young age groups and assess for brain changes over time, according to Lineback.

A limitation of the study is that it is a retrospective analysis, which means the findings cannot prove the brain changes were caused by high blood pressure.

Co-authors are Simin Mahinrad, M.D., Ph.D.; Yufen Jennie Chen, Ph.D.; Todd Parrish, Ph.D.; Donald M. Lloyd-Jones, M.D., Sc.M., FAHA; and Farzaneh A. Sorond, M.D., Ph.D.

The study was funded by the National Heart, Lung, and Blood Institute and the National Institutes of Health. The list of authors’ disclosures is available in the abstract.

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Additional Resources:

The American Stroke Association’s International Stroke Conference (ISC) is the world’s premier meeting dedicated to the science and treatment of cerebrovascular disease. ISC 2022 will be held in person in New Orleans and virtually, Feb. 8-11, 2022. The three-day conference will feature more than 1,500 compelling presentations in 17 categories that emphasize basic, clinical and translational sciences as research evolves toward a better understanding of stroke pathophysiology with the goal of developing more effective therapies. Engage in the International Stroke Conference on social media via #ISC22.

About the American Stroke Association

The American Stroke Association is devoted to saving people from stroke — the No. 2 cause of death in the world and a leading cause of serious disability. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat stroke. The Dallas-based association officially launched in 1998 as a division of the American Heart Association. Connect with us on, Facebook, Twitter or by calling 1-888-4STROKE.


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