Aggressive blood pressure treatment may also pose a risk for the brain. Dutch research published in JAMA Neurology shows that people who have low diastolic blood pressure are more likely to have brain atrophy, especially if blood pressure is lowered further.
More than 600 patients with vascular disease were followed for almost four years. MRI images were taken of their brains at the beginning and again at the end of the trial. Blood pressure was also carefully monitored.
Two thirds of the subjects in the study were taking blood pressure medication. Those with diastolic blood pressure of 70 or less had greater brain shrinkage. This complication was accentuated in those patients whose blood pressure dropped during the study. The authors conclude that lowering blood pressure in patients with low diastolic readings might be harmful to the brain.
You might wonder how this even happens. Sometimes a physician gets very aggressive in trying to control systolic blood pressure (the upper number). Someone with high systolic and low diastolic may end up on several medications. That can bring the diastolic measurement below 70. This research suggests that such an approach might be counterproductive.
You may also wish to read about the reconsideration of aggressive blood pressure control. An overview published in JAMA Interrnal Medicine (online, May 13, 2013) reveals that that pharmaceutical industry has had a great deal of influence on treatment guidelines. Here is a link to our article about this controversial issues.
[JAMA Neurology, online, June 10, 2013]
