Shocking discovery: Blood pressure has not increased but the brain has aged

High blood pressure is a leading risk factor for stroke and dementia, but brain damage can begin long before blood pressure rises. The findings open up a whole new way of understanding the link between blood pressure and brain health.

High blood pressure silently destroys the brain before blood pressure increases - Photo: Stock

The research results of Weill Cornell Medical College and the Feil Family Mind and Brain Research Institute (USA) have just been published in the journal Neuron , showing that abnormalities appear at the gene level of each brain cell after only three days of causing high blood pressure in a mouse model, at a time when blood pressure index is still completely normal.

Accordingly, disturbances in brain cells and blood vessels occur silently in the pre-hypertensive stage. These changes lay the foundation for later cognitive decline, including vascular cognitive decline and Alzheimer's disease.

Dr. Costantino Iadecola, Director of the Feil Institute for Brain and Mind Research, said many current antihypertensive therapies are very effective in controlling blood pressure but do not improve brain health.

This raises questions about the actual mechanism by which high blood pressure is so closely linked to memory loss. New research suggests the answer may lie in microscopic damage that occurs much earlier than previously thought.

To simulate the process of increased blood pressure, the team used the hormone angiotensin to trigger a similar response in humans.

They assessed brain cell activity after three days and 42 days. The results showed that as early as day three, three types of cells began to decline.

Endothelial cells lining blood vessels show premature aging, lower energy metabolism, and signs of blood-brain barrier leakage.

Interneurons lose the balance between excitation and inhibition, similar to the pattern of disorder in Alzheimer's disease. Oligodendrocyte cells, which cover nerve axons with myelin, reduce the expression of genes that maintain this protective layer. If myelin weakens, the ability to transmit signals between brain cells also decreases, directly affecting memory and thinking.

By day 42, when blood pressure had risen significantly and cognitive decline was evident, the genetic changes in brain cells had deepened. The magnitude of the early changes was unexpectedly greater than expected and could be an “important clue” to preventing early neurodegeneration, said study co-author Dr. Anthony Pacholko.

The team also tested angiotensin receptor blockers, which are commonly used to treat high blood pressure.

The drug has been shown to reverse early endothelial and neuronal dysfunction in mouse models. Some observational data in humans also suggest that this class of drugs may have a greater benefit on cognitive function than other antihypertensive drugs.

Still, experts stress that the top priority is to treat high blood pressure to protect the heart and kidneys. New research suggests that controlling blood pressure may have an even deeper benefit: preventing subtle changes in the brain that occur before symptoms appear.

Dr. Iadecola and his colleagues are now continuing to study how premature aging of small blood vessels can lead to disorders in glia and oligodendrocytes. The long-term goal is to find therapies that can prevent or reverse this decline, helping to preserve cognitive function before the damage becomes irreversible.

The findings suggest that monitoring and controlling blood pressure is not only important for heart health, but also essential for the brain.

Damage can begin very early, while clinical signs are still subtle. Early detection and intervention may be key to preventing long-term consequences for memory and thinking.

MINH HAI

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