What’s the Deal With Blood Pressure, Cholesterol, and Alzheimer’s Risk?

No one can tell for certain if you’ll develop Alzheimer’s disease 10, 20 or 30 years from now — but you can certainly lower your risk. Many factors for developing Alzheimer’s and other forms of dementia are not genetic — and certain variables could be modified through lifestyle changes. 

Among the most prevalent risk factors are high blood pressure and cholesterol levels.  These conditions don’t cause any symptoms and as a result at least 46 percent of people with high blood pressure and 40 percent of people don’t know they have them. High blood pressure can damage the blood vessels around the brain, impairing the flow of nutrients to brain cells and making them more vulnerable. High levels of cholesterol can also increase blood pressure. High blood pressure also impairs the brain’s ability to clear out beta-amyloid plaques — problematic proteins that clump up in the brains of people with the disease. 

While cholesterol from the blood cannot enter the brain because the molecule is too large, abnormalities in cholesterol metabolism in the brain are being studied as potential contributors of Alzheimer’s.

Lower blood pressure and cholesterol, lower dementia risk

According to current guidelines from the American Heart Association and the American College of Cardiology, blood pressure-lowering medication may be prescribed when blood pressure reaches levels of 130/80 mm Hg. An emerging body of research suggests these medications also help the brain.

A 2021 study looking at more than 12,000 people over the age of 50 found that taking a blood pressure-lowering medication reduced the risk of developing mild cognitive impairment — which can be a precursor to dementia — by nearly one fifth.  

An earlier study conducted in a smaller sample showed similar findings, suggesting that blood-pressure and cholesterol-lowering medications can reduce the risk of developing dementia by 21 percent.

A 2024 study looked at 31,250 adults over 60 without dementia in 14 countries across six continents. Untreated high blood pressure was linked to a 42 percent higher chance of developing Alzheimer’s disease. Getting blood pressure under control restored the risk to baseline. 

In addition to medication, there are other proven methods to improve vascular health.

Modifying diet to reduce Alzheimer’s risk

Mediterranean-style diets — rich in whole grains, fruits, berries, vegetables, seafood, fish, beans, and nuts — have long-been associated to longevity and improved brain health. One study on a similar diet designed to promote vascular health was found to lower Alzheimer’s risk by at least 35 percent.

There are all kinds of reasons why this may be the case: For example, eating fish, reducing sugar intake, and the antioxidants found in berries are also linked to better brain health. But it could be as simple as the fact that these diets also reduce blood pressure and promote healthy levels of cholesterol.

Along with your physician, you can develop a healthy plan incorporating ways to lower your blood pressure to a healthy level and eating habits that contribute to better brain health. While it isn’t certain exactly what causes some people to develop Alzheimer’s or other forms of dementia, it is possible to delay onset or reduce one’s chances of developing the disease at all.

UPDATE, October 1, 2024: This April 2022 article was updated with 2024 research around a large-scale, global study on blood pressure risk to keep our readers up to date.