Brain health and hypertension: a silent but dangerous connection

Hypertension or high blood pressure is a rapidly growing health problem in all age groups around the world with an increasing prevalence in adults and adolescents, especially in urban and developing countries. The sedentary lifestyle, obesity and food changes are the main guilty. A WHO report on hypertension in 2023 says that around the world, around 1.28 billion adults aged 30 to 79 years suffer from hypertension and it should increase up to 1.5 billion in 2025. Less than 1 of the 5 people with hypertension have their blood pressure under control and uncontrolled hypertension remains a major public health challenge. It represents about half of all the deaths of heart disease in the world followed by a stroke that people face due to hypertension. In 2015, deaths by ischemic stroke linked to a high PA were 1.5 million (50% of deaths per ischemic stroke), deaths of hemorrhagic stroke 2 million (58.3%).What can we do hypertension? Although it is easily diagnosed, hypertension remains one of the main causes of fatal complications, in particular linked to the brain and the nervous system. High blood pressure is often called “silent killer” because it can quietly damage our body for years before notable symptoms appear. If it is not controlled, it affects several organs and systems, leading to serious health complications. Hypertension can lead to serious health problems, including heart attack, heart failure, aneurysm, cerebral accidents, cognitive decline, dementia, vision loss, kidney damage, pulmonary hypertension, erectile dysfunction and even the loss of members due to peripheral blood disease.Hypertension and brain healthHypertension is a major factor contributing to stroke and aneurysm, two of the most serious and fatal consequences of uncontrolled high blood pressure. A high blood pressure causes continuous tension on the arteries, weakening their walls over time. In the brain, this can lead to an ischemic stroke, where the narrowed or blocked arteries restrict blood flow, or a hemorrhagic stroke, where a broken vessel leads to bleeding in the brain. Both types can cause permanent neurological damage, handicap or death. In addition, prolonged hypertension increases the risk of cerebral aneurysms – highlighting weakened sections of the brain arteries which can break unexpectedly, causing a sudden and often fatal hemorrhagic stroke. These conditions are not only medical emergencies, but also causes of head of long -term cognitive and physical impairment.Chronic hypertension damages the structure and function of brain blood vessels, leading to both small and large diseases, which increases the risk of cognitive decline, vascular dementia and even Alzheimer’s disease. It is a leading risk factor in the leading cognitive decline and dementia. Early detection, coherent management and lifestyle changes play a vital role in preserving brain health, which helps reduce the burden of neurological diseases, which paralyzes and leads us to a handicap.The high PA has continuous stress on blood vessels, causing damage and narrowing of the arteries that provide the brain, resulting in a reduction in blood flow and depriving cerebral cells of oxygen and vital nutrients. Over time, this results in memory loss and forgetting due to the altered function, the difficulties of attention and the concentration of a reduced activity in the prefrontal cortex, and the slower treatment speeds, because damage to the white substance bother neuronal communication. Persistent hypertension also increases the risk of vascular dementia and Alzheimer’s disease by accelerating brain atrophy and the accumulation of harmful proteins.The prevalence of cognitive impairment is significantly higher in people with hypertension. Up to 41% of people are likely to be affected by cognitive impairment compared to those with normal blood pressure, and the risk increases more with more serious hypertension.Early detection and effective management of hypertension are crucial to prevent the complications of brain healthWhen the blood pressure is too high for a long period (hypertension), it can damage the protective barrier in the brain called hemato-encephalic barrier (BBB). Normally, the BBB acts as a safety door, keeping harmful substances out of the brain while letting the nutrients enter the brain. But with high blood pressure, this barrier can become fleeing, allowing toxins and undesirable substances to enter the brain, which can accelerate the problems of memory and thought, and increase the risk of dementia.High blood pressure also reduces the amount of blood flowing towards important parts of the brain, in particular the areas involved in thought and memory, causing other damage to brain cells. It may make more difficult to plan, make decisions, quickly process information and, to a lesser extent, to remember things. Research shows that people with high blood pressure who do not take medication are more than four times more likely to develop reflection and memory problems, while those who take drugs still have about twice the risk compared to people with normal blood pressure.The good news is that the capture and treatment of early arterial hypertension can reduce the risk of developing dementia up to 30% in the elderly. In short, keeping blood pressure under control is very important to protect the brain and remain mentally sharp as we age.(By, Dr Sharan Srinivasan, stereotaxic and functional neurosurgeon and CMD, Prs Neuroscience and mechatronics Research Institute)