Hypertension: a higher risk of dementia for women

There is currently no effective treatment for dementia. It is therefore crucial to identify the most effective means of preventing this disease. A new study has found that smoking, diabetes, high body fat, stroke and low socioeconomic status were all equally strong risk factors for dementia in men as in women.

However, hypertension, or high blood pressure, was associated with a higher risk of dementia in women than in men. And this, after the researchers had taken into account the other risk factors. The results suggest that a more personalized approach to treating high blood pressure is warranted. Dementia involves the progressive loss of memory, cognitive abilities and the ability to perform daily tasks.

According to the World Health Organization (WHO), approximately 50 Millions of people worldwide have dementia. Each year, there are nearly million new cases.

Although there is currently no curative or therapeutic treatment to slow the progression of the disease, scientists have identified several risk factors.

So certain lifestyle changes and drug treatments can reduce these risks, helping to prevent the onset of the disease in the first place.

The cardiovascular problems such as high blood pressure have emerged as particularly important risk factors for dementia. A few studies have shown that, all other things being equal, hypertension puts women at a higher risk of dementia than men.

Factors that increase the dementia risk

A new study, which followed more than half a million people, adds to the evidence that high blood pressure in middle age puts women at a higher relative risk of dementia, even controlling for other risks. The researchers found that smoking, diabetes, high body fat, and low socioeconomic status all have the same impact on dementia risk in men and women. The study, by researchers at the George Institute for Global Health at the University of New South Wales in Newtown, Australia, is published in the journal BMC Medicine.

This study suggests that a more individualized approach to blood pressure treatment in men compared to women could result in even greater protection against the development of dementia.

Un half a million volunteers

Researchers followed 502 502 people in the UK Biobank, a biomedical database that recruited volunteers between 2006 and 2010. At the time of recruitment, none of the participants suffered from dementia. Their average age was 068, 5 years old. Over the following 24 years, 4 56 of them developed dementia.

Smoking, diabetes, high body fat, prior stroke and low socioeconomic status at study entry were associated with a similar increase in dementia risk in women and men. However, although the overall incidence of dementia was higher in men than in women, high blood pressure was associated with a higher relative risk in women after controlling for all other risk factors.

Specifically, as men’s systolic blood pressure increased from low to high, their risk of dementia decreased, then increased again, in a curve U shape. In contrast, the risk of dementia was higher in women than in men. Dementia risk remained stable in women with low systolic blood pressure and then increased steadily with increasing blood pressure. This type of steady, or linear, increase in risk is sometimes known as a dose-response relationship.

This sex-related difference in risk associated with increased blood pressure was apparent for both vascular dementia and Alzheimer’s disease.

Differences in treatment between men and women

The researchers believe that their results may reflect differences in the medical treatment of high blood pressure between men and women. Previous research has suggested that, overall, women take more different medications and are less likely to adhere to recommended usage than men.

Whether it is plausible that sex differences seen in blood pressure in relation to dementia risk may be related to biological differences between women and men, disparities in medical treatment may also offer some explanation. This lack of adherence could be due to women experiencing more unpleasant side effects.

Furthermore, the dose-response association between systolic blood pressure and dementia in women may be due to the fact that hypertension is less well managed in women than in men, given less adherence to treatment on average, compounded by greater polypharmacy and more treatment-related side effects.

Sources

Dementia. WHO

Sex differences in the association between major cardiovascular risk factors in midlife and dementia: a cohort study using data from the UK Biobank

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dementia 2010 Hypertension women’s health

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