Blood pressure risk for African Americans poses Alzheimer’s threat

A recent research study released by Rutgers University regarding extremely high blood pressure rates among inner-city African Americans highlights concerns that this same population group is facing abnormally high risk for developing Alzheimer’s disease and other forms of dementia. Compared to the national average, inner-city African Americans were found by Rutgers researchers to be five times more likely to have hypertensive emergency, which is defined as extremely high blood pressure that leads to strokes, heart attacks and acute kidney damage.

Researchers at the Alzheimer’s Association have found that these same high blood pressure risks are leading risk factors for the development of Alzheimer’s and other forms of dementia. Overall, African Americans are considered the population group at highest risk for developing dementia: double the rate for the average person in the U.S.

“This is a medical crisis of epic proportions,” said Rosalyn Reese, director of Diversity and Inclusion for the Colorado Chapter of the Alzheimer’s Association. “Along with age and heredity, lifestyle helps define our risk for developing dementia, and high blood pressure is among the leading risk factors for African Americans.

“While February – Black History Month – is a time to celebrate the accomplishments of African
Americans, it also should be a time when we recognize the risks that our people face from diseases like Alzheimer’s,” said Reese. “It is somewhat ironic that Dr. Solomon Carter Fuller, the first African American psychiatrist in the United States and the grandson of a slave, worked side by side with Dr. Alois Alzheimer on his pioneering work on this deadly disease, and his descendants are at the highest risk for developing Alzheimer’s disease.”

Rutgers research This most recent study from Rutgers University used data from the emergency department of Newark Beth Israel Medical Center, a New Jersey hospital that serves predominantly African-American communities. Rutgers investigators analyzed the medical records of 3,568 patients with elevated blood pressure, and identified severe increases in blood pressure were present in 50 percent of the studied patients. Among the Rutgers findings, investigators reported that the highest risk for develop high blood pressure was in patients who were male, 65 years or older, or had diabetes, chronic heart disease, or chronic kidney disease. These risk factors also led to potentially life-threatening complications, such as heart attack and worsening congestive heart failure.

Cognitive benefits of controlling blood pressure
The health benefits of reducing blood pressure were identified in a recent Wake Forest University study, the SPRINT MIND study, which the Alzheimer’s Association has announced it will extend for an additional two years.

The Journal of the American Medical Association on Jan. 28, 2019, published the results of the SPRINT MIND study, “Effect of Intensive vs. Standard Blood Pressure Control on Probable Dementia,” which showed that intensive medical treatment to reduce blood pressure can significantly reduce the occurrence of mild cognitive impairment (MCI), a known risk factor for dementia.

“Everyone who experiences dementia passes through MCI,” said Reese. “What is good for the heart is good for the brain and, conversely, if we don’t take care of our heart, we are putting our brain and our mental health at an unnecessary risk.” The SPRINT MIND study was the first randomized clinical trial of its kind, and it found a 19 percent reduction in risk of MCI when the systolic blood pressure goal was lower than 120 mm Hg. versus a standard care strategy target of 140 mm Hg.

Exploring lifestyle impacts on dementia risk
The Alzheimer’s Association also has launched a parallel two-year clinical trial, U.S. POINTER, which will evaluate whether lifestyle interventions can protect cognitive function in older adults at risk for cognitive decline. Those interventions include physical exercise, nutritional counseling and modification, cognitive and social stimulation, and improved self-management of health status.