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Cerebral small vessel disease, hypertension increase cognitive impairment risk

Cerebral small vessel disease in people with high blood pressure can cause lesions in the brain that lead to cognitive impairment, and a study suggests medication does not help.

By Tauren Dyson

Jan. 4 (UPI) -- High blood pressure, in combination with periventricular white matter hyperintensities progression, could bring on cognitive impairment, even with medication to lower blood pressure, a new study says.

New research published in the journal Hypertension showed that, among 345 men and women over age 65 with hypertension, 9 percent developed cerebral small vessel disease, bringing with it a higher risk of developing mild cognitive impairment. This can ultimately lead to dementia.

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"The brain is an organ exposed to a high volume of blood flow and it is very vulnerable to sustained high blood pressure levels, and this might be happening silently or with mild symptoms, but that doesn't mean there aren't consequences," Joan Jiménez Balado, a doctoral student at the Institut de Recerca Hospital Vall d'Hebron in Barcelona, Spain, and study lead author, said in a news release.

Cerebral small vessel disease, a common neurological disease that normally strikes older people, causes stroke and dementia, according to the British Medical Journal. To diagnose cerebral small vessel disease, doctors look for signs of white matter hyperintensities progression and visible perivascular spaces, along with other conditions.

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Untreated high blood pressure can lead to cerebral small vessel disease.

The Centers for Disease Control and Prevention estimates that about 75 million people in the U.S. have high blood pressure, which also increases the risk of heart disease and stroke.

Hypertension has already been linked to dementia. But this latest study gets closer to figuring out what small indicators create a link between dementia and high blood pressure.

To figure out that connection, scientists peered into the white matter, which attaches to different areas of the brain. The periventricular white matter sits in the central portion of the brain and serves as a key player in helping cognitive function. So when lesions or irregularities arise in the white matter area, that could point to cognitive impairment.

In the study, researchers discovered that patients with periventricular white matter abnormalities progression displayed a six-fold increased risk of mild cognitive decline. It also showed that these abnormalities were associated with small vessel bleeding within the brain and a decrease in cognitive "global and executive function."

If the lesions go untreated, they can lead to sharper cognitive decline.

"High blood pressure and its consequences are really 'covert' diseases that tend to progress if it is not well managed," Balado said.

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