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Feel dizzy when standing up? You may have a higher risk of dementia, warn researchers

People's blood pressure when they move from sitting to standing should be monitored as controlling these could help preserve people's thinking and memory skills
PUBLISHED AUG 8, 2020
(Getty Images)
(Getty Images)

Some people who feel dizzy or lightheaded when they stand up may have an increased risk of developing dementia years later, according to researchers. The condition called orthostatic hypotension occurs when people experience a sudden drop in blood pressure (BP) when they stand up.

The authors found the link with dementia only in people who have a drop in their systolic blood pressure (pressure in the blood vessels when the heart beats), not in people with only a drop in their diastolic blood pressure (the pressure when the heart is at rest) or their blood pressure overall. Systolic is the first or top number in a blood pressure reading.

For the analysis, systolic orthostatic hypotension was defined as a drop of at least 15 millimeters of mercury (mmHg) after standing from a sitting position. "People's blood pressure when they move from sitting to standing should be monitored. It’s possible that controlling these blood pressure drops could be a promising way to help preserve people's thinking and memory skills as they age," explains study author Dr Laure Rouch, University of California, San Francisco, in the analysis published in Neurology. It is the official journal of the American Academy of Neurology.

Dementia is one of the major causes of disability and dependency among older people worldwide. It is a syndrome in which there is deterioration in memory, thinking, behavior and the ability to perform everyday activities. Globally, around 50M people have dementia and there are nearly 10M new cases every year, according to the World Health Organization (WHO).

Funded by the National Institute on Aging, the research team involved 2,131 people who were an average age of 73 years and did not have dementia at the time of enrollment.
"Orthostatic hypotension has been associated with an increased risk of cardiovascular events and all-cause mortality, but the relationship with cognitive outcomes is less clear. Thus, the aim of our study was to investigate the association between repeatedly assessed postural changes in blood pressure, orthostatic hypotension, and visit-to-visit variability of postural changes in blood pressure, and risk of dementia in the prospective Health, Aging, and Body Composition (Health ABC) study," says the team.

People’s blood pressure when they move from sitting to standing should be monitored (Getty Images)

The blood pressure readings of study participants were taken at the start of the study and then one, three and five years later. A total of 15% had orthostatic hypotension, 9% had systolic orthostatic hypotension and 6% had diastolic orthostatic hypotension. Over the next 12 years, the participants were evaluated to see if anyone developed dementia. A total of 462 people or 22% developed the disease, reveals analysis.

According to the research team, the people with systolic orthostatic hypotension were nearly 40% more likely to develop dementia than those who did not have the condition. An estimated 26% or 50 of the 192 with systolic orthostatic hypotension developed dementia, compared to 21% or 412 of the 1,939 people without it. When the authors adjusted for other factors that could affect dementia risk such as diabetes, smoking and alcohol use, those with systolic orthostatic hypotension were 37% more likely to develop dementia.

The researchers also found that people whose sitting-to-standing systolic blood pressure readings changed the most — from one visit to another — were more likely to develop dementia years later than people whose readings were more stable. The people were divided into three groups based on how much their readings changed over time. A total of 24% of people in the group with the most fluctuation in systolic readings later developed dementia, compared to 19% of the people in the group with the least fluctuation. When the team adjusted for other factors affecting dementia risk, those in the highest group were 35% more likely to develop dementia than those in the lowest group. 

The researchers note that the study is observational and does not show cause and effect. It only shows an association between blood pressure readings and the development of dementia. "In this study, systolic but not diastolic orthostatic hypotension assessed at several time points was associated with a higher risk of incident dementia over the 12 years of follow-up. This relationship was independent of demographics and medical comorbidities. Visit-to-visit seated systolic BP postural changes variability were associated with greater dementia risk. Our findings raise the question of potential preventive interventions to control orthostatic seated systolic BP and its fluctuations," the authors stated. 

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