People with high blood pressure between the ages of 20 and 40 may experience brain changes later in life that increase their risk of cognitive decline, the preliminary results of a new study suggest.

High blood pressure is estimated to affect almost one million people in Ireland and is a major risk factor for cardiovascular disease and stroke.

Previous studies have found that high blood pressure disrupts the structure and function of the brain’s blood vessels, damaging parts of the brain that are key for cognitive function.

“There are studies to suggest changes to the brain may start at a young age. Our study provides further evidence that high blood pressure during young adulthood may contribute to changes in the brain later in life,” commented the study’s lead author, Dr Christina Lineback, of Northwestern Memorial Hospital in Chicago, US.

The study analysed 30 years of follow-up including MRI brain images that were performed once at the age of 30 and then again at midlife in142 adults from the Coronary Artery Risk Development in Young Adults (CARDIA) study.

This is an ongoing study involving over 5,000 people who have been followed for over 30 years.

The researchers found that younger adults who had higher cumulative blood pressure exposure had more changes visible on brain imaging at midlife (average age 55), which may increase the risk of cognitive dysfunction in mid and later life.

Furthermore, the brain changes that occurred were similar across all races and ethnicities.

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

The researchers acknowledged that 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. However, they suggest 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.

The preliminary findings were presented at the American Stroke Association’s International Stroke Conference 2022, which was held in New Orleans in early February.