Hypertension during mid or late adulthood is associated with a higher risk of cognitive impairment. However, the exact changes in late-life brain structure and pathology are uncertain. The objective of this study is to identify the association between the change in blood pressure during mid or late adulthood and the brain structure, pathology, and cognition.

This study was a part of the ongoing longitudinal, birth cohort study that included a total of 465 individuals. The participants were aged 69-71, and all were dementia-free. Blood pressure measurements of the participants were taken at ages 36, 43, 53, 60-64, and 69 years. The primary outcomes were white matter hyperintensity volume (WMHV), brain volumes, and impaired cognition. 

The increase in systolic (SBP) and diastolic blood pressure (DBP) was positively associated with WMHV. Higher DBP and SBP at age 43 was associated with the reduced whole-brain volume. Higher levels of SBP at 36-43 years of age were also linked to smaller hippocampal volumes at age 69-71 years.

The research concluded that high, increasing systolic and diastolic blood pressure from early adulthood and midlife was associated with increased WMHV, smaller brain volumes, and smaller hippocampal volumes at age 69-71. However, no associations between high blood pressure levels and cognitive impairment were established. 

Ref: https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(19)30228-5/fulltext