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High blood pressure is a risk for (MCI) mild cognitive impairment

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Close up of digital monitor device with cuff showing high diastolic and systolic blood pressureDid you know that high blood pressure puts you at risk for developing Mild Cognitive Impairment (MCI)? The problem is, MCI can eventually develop into dementia and Alzheimer’s disease.

A recent study involving 9,400 adults that was published in JAMA (January 28, 19) indicates that you can reduce your risk of MCI by lowering your blood pressure.  Adults in their 50s or older with high blood pressure participated in a clinical trial led by scientists at the Wake Forest School of Medicine in Winston-Salem, NC. The purpose of the trial was to evaluate the effect of blood pressure control on risk of dementia. The participants received either intensive blood pressure control or standard treatment.

Intensive control was used to bring systolic blood pressure below 120 millimeters of mercury (mm Hg), while the purpose of standard treatment was to lower it to under 140 mm Hg. Systolic blood pressure is the pressure in the arteries when the heart contracts. It is the top number in a blood pressure measurement, as in 120 mm Hg over 70 mm Hg.

The results revealed that significantly fewer of those who received intensive blood pressure control went on to develop Mild Cognitive Impairment, compared with those on the standard treatment. The lead investigator Dr. Jeff D. Williamson said that “three years of lowering blood pressure not only dramatically helped the heart, but also helped the brain.”

However, the study did not show that intensive blood pressure control reduced the incidence of dementia. The authors suggested that low numbers and the study finishing earlier than planned could be reasons for this.

What is Mild Cognitive Impairment? 

MCI is a condition in which the individual has some loss of mental acuity, such as forgetting appointments, losing the flow of a conversation, and difficulties making decisions and keeping track of finances, as well as trouble with reasoning. The individual is still able to care for him or herself and live a fairly normal life.

Approximately 15 to 20 percent of people 65 and older have MCI. People living with MCI are more likely to develop Alzheimer’s disease or other dementias. But MCI doesn’t always lead to dementia. In some cases, MCI remains stable or resolves on its own. Some medications may result in symptoms of MCI, including forgetfulness or other memory issues.

There are no pharmaceutical drugs approved in the U.S. for the treatment of MCI. However, the study discussed above, is a good indication that high blood pressure that is controlled through changes in lifestyle can help prevent MCI.

Why is high blood pressure dangerous?

It’s called the “silent killer” because it is insidious. It often has no warning signs or symptoms.

If your blood pressure is high it causes strain on the vessels carrying blood throughout your body. This can injure the vessels and lead to plaque buildup as a response to injury. Eventually, this can lead to narrow blood vessels and then clotting of passageways, which can cause damage to the heart and/or brain. High blood pressure ultimately increases your risk for getting heart disease, kidney disease, dementia, and for having a stroke.

Taking Your Blood Pressure

When your doctor takes your blood pressure, he/she is measuring the pressure in your arteries as your heart pumps. The heart contracts and relaxes during each heartbeat. When it contracts, the blood is being pumped out of the two ventricles (chambers) and your blood pressure goes up. Systolic pressure (the top number in the blood pressure reading) is the peak reading of the pressure produced by this contraction.

When the heart relaxes, blood fills the ventricles and your blood pressure goes down. The diastolic pressure (the bottom number in the blood pressure reading) measures the pressure between the beats as the heart relaxes.

What’s normal blood pressure?

High blood pressure used to be considered 140/90 or higher.

According to the National Heart, Lung and Blood Institute (a division of the Institutes of Health), normal blood pressure is now considered to be lower than 120/80 according to the guidelines released in November 2017.

The guidelines state that for BP above 115/75, every rise of 20/10 mm Hg doubles the risk of cardiovascular disease. Since 2017, the American Heart Association has advised that people with high BP should receive treatment at 130/80 rather than 140/90.

In the new guidelines, the AHA also recommends that doctors only prescribe medication in cases of a previous heart attack or stroke, or in the presence of risk factors such as: age, diabetes, or chronic kidney disease. Rather, at the earlier stages of hypertension, another word for high blood pressure, patients should make lifestyle changes. Here are a number of ways to do that:

10 Ways to support healthy blood pressure and prevent MCI

  1. Eat a nutritious, high-fiber, low-fat heart healthy diet. Learn about the MIND diet.
  2. Beware of your intake of sodium.
  3. Include foods high in phytonutrients—fruits and veggies.
  4. Take nutritional supplements proven to support a healthy heart: magnesium, potassium, B vitamin complex, vitamin D3, CoQ10, Grape seed extract, Resveratrol, Quercetin.
  5. Avoid decongestants if possible. These drugs can raise blood pressure.
  6. Practice a stress reduction technique such as yoga or meditation.
  7. At the minimum, take a walk 3-4 times a week.
  8. Stop smoking and reduce consumption of alcohol.
  9. Drink 6 to 8 glasses of water every day.
  10. If you snore, have sleeping problems, or are sleepy during the day, discuss sleep apnea with your physician.

Give yourself the gift of peace and get plenty of rest and sleep.

Happy Holidays!

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Are you putting yourself at risk for dementia with OTC medications and prescription drugs?

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Reading Instructions from PharmacyA new study links the increased risk of dementia with certain medications. (Anticholinergic drugs and risk of dementia: case-control study) The focus of the study was on drugs that have anticholinergic effects. Acetylcholine is vital to memory and learning. There are lower levels of this neurotransmitter in the brains of people with Alzheimer’s disease. Additionally, animal studies have shown that anticholinergic drugs may contribute to brain inflammation, another risk factor for dementia.

It’s estimated that approximately 50% of adults in the U.S. take one or more medications with an anticholinergic effect. Some of the most common are:

  • amitriptyline (Endep, Elavil), paroxetine (Paxil, Pexeva), and bupropion (Aplenzin, Wellbutin). These drugs are commonly taken for depression)
  • oxybutynin and tolterodine, taken for an overactive bladder, found in Ditropan, Oxytrol.
  • diphenhydramine, a common antihistamine found in: Advil PM, Aleve PM, Bayer PM, Benadryl, Excedrin PM, Nytol, Simply Sleep, Sominex, Tylenol PM, Unisom, etc.
  • Chlorpheniramine, found in Actifed, Allergy & Congestion RElief, Chlor-Trimeton, Codeprex, Efidac-24 Chlorpheniramine, etc.

According to Shelly Gray, professor pharmacy at the University of Washington, and author of  Cumulative Use of Strong Anticholinergics and Incident Dementia” (March 2015, JAMA Internal Med.), the longer people took the drugs and the higher the dose, the higher the risk of dementia, although it’s important to note that short-term use was not linked to higher risks.

Gray suggested that people, especially seniors, who have trouble sleeping find a non-drug therapy for insomnia Celexa and Prozac for depression and Claritin for allergies.  She emphasized that it is important to speak with one’s doctor before stopping a medication that you have been taking.

Natural alternatives

Help for depression

  1. Get some physical exercise every day; even just a 20 minute walk helps tremendously.
  2. Use aromatherapy oils. For more information about the use of aromatherapy to reduce stress, improve immunity, reduce agitation, and to promote relaxation read chapter 18 “Aromatherapy” in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn
  3.  I gave my husband Ginkgo biloba for depression (and also took it myself). It helped right up until he was in late stage Alzheimer’s. One word of advice, not all brands are efficacious, so pick one carefully. Also note that it takes about 6 weeks to notice an effect. This is a typical difference of taking a pharmaceutical versus a natural remedy.
  4. Vitamin B complex optimizes cognitive activity and brain function, has a positive effect on memory, learning capacity and attention span, and supports a healthy nervous system and a stable mood. Vitamins B6 and B12, in particular, play a role in the synthesis of serotonin, the neurotransmitter linked to improving memory, lifting mood and regulating sleep.
  5. Omega-3 fatty acids are rich in DHA, the major unsaturated fat in the brain. This long-chain fatty acid provides the necessary fluid quality to the membranes of the nerve cells so that electrical nerve impulses can flow easily along the circuits of the brain. One study found that Alzheimer’s patients given an omega-3-rich supplement experienced a significant improvement in their quality of life.
  6. Maintain your social connections. Loneliness can actually lead to health problems and mental decline. Join a group—any kind of group: worship,  hiking, scrabble, table tennis, knitting, discussion group, or book club. Volunteer at a food bank, soup kitchen or animal shelter. It’s important to stay connected and to feel as though you are a contributing member of society.

Natural sleep aids

  1. Try valerian, passion-flower or skullcap herbal tea at least a couple of hours before bedtime.
  2. A cup of warm milk with a small pinch of cardamom, coriander, cinnamon, turmeric and cumin, and an 1/8 of a tsp of ghee is a tasty and relaxing bedtime drink. The calcium in the milk is a muscle relaxant and the Indian spices help induce relaxation. Experiment to see which spices you like.
  3. Eat a banana. Bananas contain potassium and magnesium that help reduce risk of muscle cramps. These two minerals also support heart health and cognitive function.
  4. A drop in blood sugar during the night can cause us to wake up. Although it’s better to not go to sleep on a full stomach, a small protein snack such as a slice of cheese or smear of peanut butter on a cracker can help maintain balanced blood sugar.
  5. Melatonin supplements help some people, but you might have to experiment with the dosage. I like Natural Vitality’s Natural Calm, a powdered calcium supplement that you put in water or juice. I also like the homeopathic remedy Hyland’s Calms Forte.
  6. Spritz lavender oil on your pillow or put a sachet of lavender flowers under your pillow.

Natural antihistamines

  1. Quercetin is a bioflavonoid that is naturally found in plant foods such as apples, cruciferous vegetables (like broccoli or cauliflower), onions/shallots, green tea and citrus fruits. It stabilizes the release of histamines and helps to naturally control allergy symptoms.
  2. Apple cider vinegar is my new “go to” remedy for almost everything. I take 1 Tablespoon everyday by pinching my nose and drinking water to flush it down. It helps alkalize the body and supports immune function.
  3. Butterbur is a natural herb that is sold as an extract. A study published in August 2005 in Phytotherapy Research found that when compared to an antihistamine, the butterbur extract worked just as well, without the side effect of drowsiness.
  4. Remember that Claritin does not contain diphenhydramine, so use it by all means if these other remedies do not do the trick.

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.