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In the real world, trying to obtain the perfect blood pressure can be questionable

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Eleanor Roosevelt once said, “You must do the things you think you cannot do.” Avoiding disease may be the gift of lucky genetics, but it helps to put some work into managing your chances for health and longevity. 

Maintaining rubbery arteries are key to the delivery of oxygenated blood to the heart’s muscle that guards against hypertension, stroke, and heart attack. A report in the Journal of the American Medical Association says that what’s good for the heart may also be good for the brain.

The study involved 9,300 people ages, 50 and older with an average age of 68, with hypertension. They also had one other cardiovascular risk factor, history of stroke, or dementia. It was a huge study involving patients in over 100 carefully supervised medical centers across the U.S.

Half of the patients were provided “Gold Standard” care. This meant they were given medication that lowered their systolic blood pressure (the top number), to less than 120. The other half simply aimed for the standard systolic target of 140 or lower.

What happened? When a study shows after a period that one group is getting the raw end of the deal, it must be stopped for ethical reasons. So, when the gold standard group was winning after a period of three years, the study abruptly ended.

The gold standard of treatment had reduced cardiovascular problems and death by 25 percent. But the study ignited the still on-going debate as to whether normal blood pressure level should be changed from 140/80 to 130/80.

There was another effect. Researchers wondered if lowering of blood pressure in the gold standard group would have any effect on the risk for dementia. So they followed these two groups further to see if changes in blood pressure had any effect on brain function.

The result? After another two years, researchers found no statistical difference in the amount of “probable dementia” between the two groups. But they did notice a 19 percent lower rate of mild cognitive impairment (MCI) in the gold standard group.

MCI is a gray, indefinable area between normal brain function and early dementia. Looking at it another way, 287 of the 4,280 patients in the gold group and 353 of the same number in the standard group, developed MCI over a five-year period. Not a huge difference, but big enough to warrant notice.

Researchers stressed that, although some cases of MCI go on to develop dementia, many others go for years without any problems. Some patients even revert to normal.

So what’s the bottom line? Good sense dictates that controlling hypertension is a sound measure for the brain, but lowering it too much can cause hypotension (low blood pressure), fainting and possible kidney injury. In effect, in the real world, trying to obtain the perfect blood pressure can be questionable.

Researchers say the best option for brain health is to stay physically active and maintain a sense of purpose in life. This is always good for the brain. Weight control, particularly in the abdomen, is essential, as it’s linked to dementia. But since obesity is so often associated with Type 2 diabetes, hypertension and dementia, it’s difficult to know which is the main culprit.

Since Type 2 diabetes narrows cerebral arteries and decreases oxygenated blood to the brain, this along with hypertension, is a bad combination.

Take Eleanor Roosevelt’s sage advice to heart. You need more than luck to avoid these two killers. Rather, your diet and lifestyle may need to undergo dramatic changes.

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Written by W. Gifford-Jones MD & Diana Gifford-Jones

Dr. W. Gifford-Jones, MD is a graduate of the University of Toronto and the Harvard Medical School. He trained in general surgery at Strong Memorial Hospital, University of Rochester, Montreal General Hospital, McGill University and in Gynecology at Harvard. His storied medical career began as a general practitioner, ship’s surgeon, and hotel doctor. For more than 40 years, he specialized in gynecology, devoting his practice to the formative issues of women’s health. In 1975, he launched his weekly medical column that has been published by national and local Canadian and U.S. newspapers. Today, the readership remains over seven million.

His advice contains a solid dose of common sense and he never sits on the fence with controversial issues. He is the author of nine books including, “The Healthy Barmaid”, his autobiography “You’re Going To Do What?”, “What I Learned as a Medical Journalist”, and “90+ How I Got There!”

Many years ago, he was successful in a fight to legalize heroin to help ease the pain of terminal cancer patients. His foundation at that time donated $500,000 to establish the Gifford-Jones Professorship in Pain Control and Palliative Care at the University of Toronto Medical School. At 93 years of age he rappelled from the top of Toronto’s City Hall (30 stories) to raise funds for children with a life-threatening disease through the Make-a-Wish Foundation.

Diana Gifford-Jones, the daughter of W. Gifford-Jones, MD, Diana has extensive global experience in health and healthcare policy. Diana is Special Advisor with The Aga Khan University, which operates 2 quaternary care hospitals and numerous secondary hospitals, medical centres, pharmacies, and laboratories in South Asia and Africa. She worked for ten years in the Human Development sectors at the World Bank, including health policy and economics, nutrition, and population health.

For over a decade at The Conference Board of Canada, she managed four health-related executive networks, including the Roundtable on Socio-Economic Determinants of Health, the Centre for Chronic Disease Prevention and Management, the Canadian Centre for Environmental Health, and the Centre for Health System Design and Management. Her master’s degree in public policy at Harvard University’s Kennedy School of Government included coursework at Harvard Medical School. She is also a graduate of Wellesley College. She has extensive experience with Canadian universities, including at Carleton University, where she was the Executive Director of the Global Academy. She lived and worked in Japan for four years and speaks Japanese fluently. Diana has the designation as a certified Chartered Director from The Directors College, a joint venture of The Conference Board of Canada and McMaster University. She has recently published a book on the natural health philosophy of W. Gifford-Jones, called No Nonsense Health – Naturally!

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