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Experts say it’s important to keep a close watch on your blood pressure. Asya Molochkova/Stocksy
  • Researchers say certain high-intensity treatments for blood pressure can help improve brain health.
  • They say the treatments work by clearing pathways in the perivascular regions of the brain.
  • Experts say you can maintain good brain health with a healthy diet, regular exercise, adequate sleep, and avoiding overstimulation.

Intensive high blood pressure treatment was more effective in improving or reversing the damage in the perivascular regions of the brain than more moderate treatment, according to a study being presented at the American Stroke Conference 2023 next week.

In the study, which hasn’t been published yet in a peer-reviewed journal, researchers analyzed brain MRI scans of 658 people.

The data came from the SPRINT-MIND Sub-Study, which began in 2010 with the final MRIs being taken in July 2016. The average age of the participants was 67 with 60 percent being women.

All participants had high blood pressure, but none had previously been diagnosed with diabetes, dementia, or stroke. There was an average of nearly 4 years of follow-up.

In their analysis, the scientists divided the participants into two groups.

One group of 243 people received high-intensive treatment for high blood pressure with a target of 120 mm Hg systolic pressure.

The second group of 199 people received standard treatment, with a target of 140 mm Hg.

All participants had a pre-study and a post-study MRI analyzed for the amount of perivascular spaces in the brain.

“Perivascular spaces (PVS) are cerebrospinal fluid-filled spaces, also called Virchow-Robin spaces, located in the innermost layer of the brain,” explained Dr. Sandra Narayanan, a vascular neurologist and neuro-interventional surgeon at Pacific Stroke & Neurovascular Center at Pacific Neuroscience Institute in California.

“They can enlarge with aging, inflammation, demyelinating disorders, or neurodegenerative processes. They help eliminate water and metabolic waste from the brain,” she told Healthline.

According to the American Heart Association, normal blood pressure is below 120/80 mm Hg. For adults, if systolic pressure (the top number) is 120 to 129 mm Hg and diastolic pressure is less than 80 mm Hg, this is classified as elevated blood pressure.

High blood pressure is a systolic pressure of 130 mm Hg or higher or a diastolic pressure of 80 mm Hg or higher that stays high over time.

At the start of the study, the volume of perivascular spaces was similar in both groups.

However, after almost four years of high blood pressure treatment, the volume of perivascular areas decreased significantly in the intensive-treatment group. It did not change in the standard-treatment group.

The researchers noted that previous research showed that effective blood pressure control is essential for brain health.

The current study suggests that perivascular areas are dynamic and it might be possible to reduce them with intensive blood pressure lowering.

This could be associated with better clearance of toxins in the brain and improved brain health. It could also contribute to reversing the effects of high blood pressure on the perivascular space, the researchers reported.

“Hypertension and elevated blood pressure have consistently been shown to worsen brain health, including cerebrovascular health and cognition,” said Dr. Yousef Hannawi, the interim director of the Division of Cerebrovascular Diseases and Neurocritical Care and Medical Director in the Neurosciences Critical Care Unit at The Ohio State University Wexner Medical Center.

“We still do not entirely understand all the mechanisms through which elevated blood pressure damage the brain and to what degree controlling the blood pressure will eliminate or reverse its downstream effects,” Hannawi told Healthline.

“Part of the dilemma is knowing the blood pressure treatment goal,” he added. “This study calls for stricter blood pressure management. But, it is a positive step forward on the way to reverse hypertensive brain damage.”

The study did not attempt to determine whether the change in perivascular spaces would improve cognitive abilities. The researchers noted that this would be the next step. However, they do hope that clearing the toxins more effectively could reduce the likelihood of developing dementia.

“Moderate blood pressure control is associated with fewer white matter hyperintensities, areas of the brain that show up as bright white in an MRI scan, and are linked to diseases, such as dementia,” Narayanan said. “Keeping hypertension under control reduces the risk of end-organ damage, such as scarring, narrowing, or blockage of fragile cerebral arteries that can cause ischemic or hemorrhagic stroke over the long term.”

“Many risk factors for neurodegenerative diseases such as advanced age tend to be progressive,” Narayanan sajd. “If some of the associated clinical features are modifiable, there are immense potential clinical implications on quality and quantity of life for these disabling and widely prevalent conditions.“

Based on the study results, monitoring and managing blood pressure is essential for a healthy brain.

The Alzheimer’s Association points to a nutritious diet, such as the Mediterranean diet that is low in fat and higher in fruits and vegetables. Exercising your mind by learning something new is also vital.

Clarissa Silva, a behavioral scientist, relationship coach, and creator of the Happiness Hypothesis Method, suggests implementing the following in your life:

  • Exercise. Aerobic exercise for at least 30 minutes daily helps the brain generate new neurons.
  • Sleep. Irregular sleeping habits inhibit optimal cognitive functioning and can exacerbate brain fog symptoms throughout the day.
  • Overstimulation. Multitasking may reduce productivity and contribute to our brain’s constant overstimulation. Focusing on single tasks and taking a break between the next job helps improve the brain’s neuroplasticity.
  • Unresolved trauma. Trauma impacts decision-making, affects self-esteem, and impairs cognitive functioning. Addressing trauma with a skilled professional can begin reversing current cognitive impairment and prevent future degenerative conditions.

“Limiting screen time can help with neuron regeneration,” Silva told Healthline. “Implementing a routine. Try to reduce dependence on checking your device as soon as you wake up and an hour before bedtime. Our brains need to repair from the constant over-stimulus we endure throughout the day.”