High Blood Pressure, also known as Hypertension (HTN), is very, very bad for brain health. It is a common condition that ruins the plumbing. Patients with a history of HTN typically have numerous lesions in their brain. These lesions commonly show up on MRI scans and are called ‘white matter lesions’, or ‘small vessel disease’, or ‘chronic ischemic change’. Neurologists commonly find themselves explaining these MRI findings to patients. All of these terms basically mean the brain has suffered numerous small strokes. The longer you’ve had HTN, and the poorer controlled it has been, the more lesions you’ll probably have.
Of course, having a brain riddled with holes and looking like swiss cheese can’t be good. And what we find is that the more of these lesions you have, the more likely you are to have cognitive impairment.
Amazingly, I remember reading a recent article that suggested for every handful of white matter lesions seen on MRI [chronic ischemic changes, small vessel changes seen], there were hundreds if not thousands more present only detetable via microscope. This is an astounding piece of information.
Importantly, we are now learning that even mildly elevated blood pressure- in the normal range- can also be associated with these lesions. New lines of evidence suggest that low range pre-hypertension 120-129/80-84 probably is bad for your brain and ups your risk of small strokes accumulating over time.