/publications/issue/2006/2006-06/2006-06-5576

HYPERTENSION WATCH

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Possible Link Between Hypertension and Dementia Found

A recent study suggests that there may be a potential link to the presence of high blood pressure in middle age and the development of dementia in old age. Some physicians are hesitant to treat hypertension in the elderly because of concerns about lowering the patients'cognitive functioning. Clinical trials show, however, that not only is there no harm in hypertension treatment, but it also may actually benefit them mentally. The results were reported in the April 6 on-line version of Stroke: Journal of the American Heart Association.

The study analyzed data on 1294 men who were taking part in a long-term study on aging. About two thirds of these men had hypertension in their middle-age years, and none had dementia at approximately age 77. Six years later, 108 of these men were diagnosed with signs of dementia, mostly Alzheimer's. The results of the study showed, however, that the longer the men were taking medicine to treat their hypertension, the less likely they were to develop dementia. Treatment of <5 years correlated to a 6% lower dementia risk, 5 to 12 years of treatment related to a 48% lower risk, and those treated for >12 years reduced their risk by 60%.


Study Shows Hypertension Drug Reverses Cell Death

Researchers at Purdue University have found that a medicine commonly used to treat high blood pressure may also reverse damage to cells caused by spinal cord injuries, cancer, and Parkinson's disease. They found that hydralazine, a drug used to relax the veins and arteries, may be an antidote for acrolein, a deadly toxin that is made after a nerve cell is injured. The findings were published in the Journal of Neuroscience (April 17, 2006).

Acrolein can remain in the body for days and is responsible for secondary damage that keeps damaged cells from healing on their own. It is a type of cell toxin called an aldehyde; hydralazine works by trapping aldehydes, neutralizing, deactivating, and secreting them. The researchers collected data on acrolein from cell cultures and found that the toxin can destroy entire cell groups in <12 hours. They also learned that more than 80% of these cells would survive if the toxin were treated with hydralazine. Researchers hope that if hydralazine is introduced early enough after initial cell damage, it may slow down the processes of diseases such as Alzheimer's and Parkinson's.


Lonely Seniors Risk Elevated BP

Researchers have found that loneliness can have a physical as well as emotional effect on people, elderly patients in particular. Lonely people have higher blood pressure (BP) readings than nonlonely people, even when depression and stress are taken into account. Differences in BP between lonely and nonlonely people were shortest at age 50 and grew as the ages increased, up to 68 years. The findings of the study from the University of Chicago were published in the journal Psychology and Aging.

The researchers studied 229 older adults and asked them a series of questions to determine if they perceived themselves as lonely. The team also examined data on weight, alcohol consumption, smoking, BP medications, and demographic characteristics. Researchers theorize that "lonely people differ from nonlonely [people] in their tendency to perceive stressful circumstances as threatening rather than challenging, and to passively cope with stress by failing to solicit?support, and by withdrawing from stress rather than?coping." The National Institute on Aging is looking at these findings to help determine what can be done for this population to improve relationships and help alleviate both loneliness and hypertension.


Stress on the Job May Not Raise BP

Contrary to popular belief, a new study shows that there may not be a correlation between job stress and elevated blood pressure (BP). A review of 48 studies on job stress and BP showed no relationship between the two, and those studies that did seem to find a relationship were weak and inconsistent. Although there was no doubt that brief confrontations on the job can raise BP for a short time, the relationship between recurring work stress and chronic hypertension has yet to be confirmed. The results of the review were published in the May 2006 issue of Current Hypertension Reviews.

Study authors reviewed data from studies published in English-language journals from 1982 to 2004. The studies included >100,000 people. Out of the 48 studies included, only 20 found any relationship between job stress and BP. Additionally, the researchers stated that only 26 of the studies looked at the relationship of job stress and BP over time, using ambulatory BP measurements, which are considered to be more precise because the measurements more accurately reflect BP in a person's natural environment. Of these studies, only 10 showed a positive relationship between job stress and systolic BP (considered a more reliable indicator of heart disease risk than diastolic BP).