When High Blood Pressure Goes Untreated, This Is What Happens To Your Brain

When you're young, high blood pressure and cholesterol might not be on your radar. As you get older, they can slowly creep up without you even noticing. High blood pressure doesn't usually cause symptoms, so you may not realize your blood pressure is rising unless you get regular check-ups. Untreated high blood pressure can increase your risk for serious health problems like heart disease, stroke, and diabetes.

But there's another reason to keep an eye on your blood pressure, even in your 30s. A 2023 study in JAMA Network Open found that having high blood pressure in your 30s and 40s could lead to brain shrinkage later in life, particularly in areas responsible for thinking and memory. Researchers found that for every 5-point increase in systolic blood pressure (the top number), the temporal cortex, which is important for language and memory, showed signs of deterioration. Similarly, each 5-point increase in diastolic blood pressure (the bottom number) was linked to shrinkage in the parietal cortex, which helps with spatial awareness and movement.

Healthy blood vessels are important in delivering oxygen and key nutrients to your organs, including your brain. When your blood pressure increases, it can damage the walls of the blood vessels, where fats and other substances can clog the blood flow. If the blood vessels in the brain are damaged, the limited blood flow to the brain can result in a stroke. This could also occur if a blood clot forms and blocks blood flow. Restricting blood flow to the brain can also cause one type of dementia called vascular dementia.

About 20% of stroke cases and 45% of dementia cases are linked to a condition called cerebral small vessel disease (CSVD), according to a 2020 study in Hypertension. CSVD can cause brain bleeds and unnoticed strokes that can damage the brain and cause dementia. The study found that people with long-term high blood pressure had a higher risk of developing CSVD than those who had normal blood pressure.

Your brain needs healthy circulation to clear out waste and toxins. If that process doesn't work well, those toxins can build up and increase the risk of dementia. A 2023 study in Stroke followed people for four years to see how controlling blood pressure affected their brains. One group followed an intense blood pressure treatment plan, while the other had standard care. By the end of the study, those with better blood pressure control had slightly smaller perivascular spaces (PVS), which are fluid-filled areas that help clear waste from the brain. This suggests that keeping blood pressure in check might help the brain stay healthier and reduce the risk of dementia.

Whether you have high blood pressure or not, you can help reduce your risk of dementia and neurodegeneration by controlling your blood pressure. The American Heart Association suggests at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise a week to control your weight, reduce stress, and lower your blood pressure. If your job requires you to sit for long periods of time, be sure to get up and walk around often.

A heart-healthy diet that limits sodium, sugar, alcohol, processed meats, and saturated fats can also help manage your blood pressure. The DASH diet, which stands for Dietary Approaches to Stop Hypertension, emphasizes whole grains, lean protein sources, beans, nuts, fruits, and vegetables. Because these foods tend to be high in potassium, calcium, magnesium, and fiber, you'll not only reduce your blood pressure but also your cholesterol.

Stress can also raise your blood pressure by sending those stress hormones through your system. Although this is a temporary response, chronic stress can build up and lead to conditions such as headaches, digestive issues, trouble sleeping, and high blood pressure. You can manage your stress and blood pressure by getting enough sleep, engaging in healthy social connections, and perhaps giving breathwork a try (here's what happens to your body when you practice breathwork).