Physicians' Academy for Cardiovascular Education

Midlife hypertension is associated with an increased risk of dementia in women

Female sex, early-onset hypertension, and risk of dementia

Literature - Gilsanz P, Mayeda ER, Glymour MM, et al. - Neurology 2017, published online ahead of print


Hypertension is more common among men compared with women in early adulthood, however, the risk of target organ damage and the CVD burden attributable to hypertension is higher in women [1]. Dementia is one of the consequences of hypertension in midlife, but gender differences in this context have not been evaluated [2,3].

In this study, the associations of BP in early (mean: 32.7 years, SD: 1.8; range: 30.0–36.0) and mid-adulthood (mean: 44.3 years, SD: 3.0; range: 40.0–55.9) with the risk of dementia later in life were evaluated, and possible gender differences were investigated.

For this purpose 5,646 members of the Kaiser Permanente Northern California (KPNC) integrated health care delivery system, who participated in the Multiphasic Health Check-ups and had their BP measured at early- and mid-adulthood were included in the analysis [4]. KPNC members were classified according to their BP at each time point as follows:

Furthermore, individuals were classified into the following 4 categories based on the changes between the 2 time points: stable normotensive, onset hypertension, remitted hypertension, persistent hypertension. The mean follow-up time for dementia was 15.3 years (SD: 6.1; range: 0.1–19.7 years).

Main results


Although midlife hypertension is more common in men, it was only associated with the risk of dementia in women. These findings may have important implications for hypertension management for women in their early 40s and brain health in later life.


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