February 2019 Issue

Editor's Spot: Hypertension's Link to Dementia
By Judith Riddle
Today's Dietitian
Vol. 21, No. 2, P. 4

I'm a member of the Sandwich Generation—a season of life in which you're wedged between young adult children and elderly parents who may need either part-time or full-time assistance or care due to chronic disease and/or dementia.

Cognitive impairment and dementia impacts around 8.6 million Americans, and this number could triple by 2050 as baby boomers age, according to the American Heart Association. Researchers believe that one reason dementia is rising is the increased rate of hypertension. Since the new diagnostic guidelines were released in November 2017, the percentage of US adults with hypertension rose from 32% to 46%. Under the new standard, a blood pressure reading of 130/80 is considered hypertension vs 140/90 under the former guidelines. Dementia hits black adults particularly hard, especially black men, as hypertension usually is diagnosed at a younger age compared with whites and is more severe. About 59% of black men have hypertension, up from 42% under the former guidelines.

A new University of Michigan study published in Hypertension sheds more light on the link between hypertension and dementia. The study found that older black adults with hypertension, most notably black men, show more severe cognitive declines than white adults with hypertension and are twice as likely to develop dementia later in life. Both of my parents developed hypertension in midlife and have been gradually showing signs of memory loss within the last five to seven years.

In the study, researchers followed more than 22,000 middle-aged and older black and white adults for eight years. Health care workers took participants' blood pressure readings at the start of the study and administered cognitive tests over the phone every 12 to 24 months. The results: Black adults with high systolic blood pressure showed faster declines in memory and new learning and comprehension compared with white adults with the condition. And men with hypertension, compared with women, showed quicker declines in new learning.

The results of this study call for additional research on the association between hypertension and dementia, and whether treating hypertension aggressively could prevent dementia and decrease racial disparities in dementia risk.

Dietitians can use these study results as talking points with clients and patients during counseling sessions on heart-healthy eating, nutrients that support brain health, and physical activity.

In honor of American Heart Month, Today's Dietitian's cover story, "Sex, Gender, & CVD," on page 18, provides an in-depth look at the different presentations of CVD in men and women.

After reading the article, turn to the other features on ethnic cuisine and the hottest trends in "natural" foods and meal replacement products. Please enjoy the issue!

Judith Riddle