Vascular dementia and high blood pressure

By lowering your blood pressure, you can lower your risk of developing vascular dementia and help stop it getting worse.

Over time, uncontrolled high blood pressure can damage your blood vessels, including the blood vessels in and leading to the brain. This can interrupt the flow of blood to the brain, leading to a type of dementia known as vascular dementia. The word ‘vascular’ refers to the blood vessels. 

What is vascular dementia?

Dementia is a group of disorders of the brain which causes symptoms including loss of memory, difficulty thinking and concentrating, and problems communicating.

Vascular dementia is the second most common type of dementia after Alzheimer’s disease. It’s caused by problems with the blood supply to the brain. Some people with vascular dementia will have Alzheimer's disease as well, which is known as mixed dementia.

Dementia is usually progressive, which means the symptoms tend to get worse over time, but it is possible to slow it down. There is also support available to those living with it.

This video from Alzheimer’s Society explains what vascular dementia is and how it develops.

How does high blood pressure cause vascular dementia?

Uncontrolled high blood pressure can damage the blood vessels, making them weaker or narrower, and more likely to burst or become blocked. This restricts the blood supply to parts of the brain, so not enough oxygen and nutrients can reach the brain cells, damaging that part of the brain.

There are three main ways high blood pressure can affect the blood supply to the brain and cause vascular dementia:

• Damage to the blood vessels in the brain – the blood vessels can become narrow and stiff, known as small vessel disease. This is the most common cause of vascular dementia
• Stroke – a stroke is where a blood vessel in the brain becomes blocked or bursts, cutting off the blood supply to part of the brain and causing damage. This is known as post-stroke dementia 
• TIA (transient ischaemic attack), also known as a mini stroke – a series of mini strokes can gradually cause damage. This is known as multi infarct dementia

What else can cause vascular dementia?

Other health problems
Any health problem which affects the blood vessels can lead to vascular dementia, including high cholesterol, heart disease and diabetes.

Lifestyle 
The lifestyle factors which lead to high blood pressure, such as smoking and lack of physical activity, can also lead to the health problems mentioned above, and in turn lead to vascular dementia.

Other risk factors
There are a number of risk factors for vascular dementia which can’t be changed, making it more important to take care of the things you can. These factors include:

• age – the risk goes up as you get older, and it’s uncommon in people under 65
• being male – men are at a slightly higher risk that women
• stroke – having had a stroke in the past
• atrial fibrillation – where the heart beat is too fast or irregular
• being of South-Asian and African and Caribbean descent – people with this background are at higher risk of diseases such as heart disease, diabetes and stroke
• a family history of stroke or heart disease

What are the signs and symptoms of vascular dementia?

The effects of vascular dementia vary from person to person and depend on which parts of the brain are affected. Some common signs and symptoms include:

• difficulty remembering things, such as recent events
• struggling to concentrate
• problems thinking, for example, taking longer to find the words you’re looking for and difficulty planning and organising
• feeling disorientated or confused
• difficulty speaking and communicating
• being unsteady, problems walking and moving around, and falls
• sight problems and loss of spacial awareness
• changes in mood, such as feeling depressed or anxious, and having mood swings

Symptoms may stay the same for a while, then suddenly get worse. This is known as stepwise progression, and can be caused by another stroke or mini stroke. With small vessel disease, symptoms might slowly get worse.

How is dementia diagnosed?

If you think you may have signs of vascular dementia, visit your GP. Getting diagnosed early could mean you get the treatment for any underlying causes that could help stop it getting worse or slow it down.

There is no one single test for vascular dementia, but the following can help diagnose it and rule out other health problems with similar symptoms, and you may be referred to a specialist:

• questions about your symptoms and assessment of any health problems you’ve had, such as high blood pressure and strokes or mini strokes
• questions about health problems in your family, such as heart disease and stroke
• tasks and questions to test your memory and mental abilities
• a brain scan such as a CT scan, which looks a lot like an X-ray but in 3D, or MRI scan, which gives a very detailed 3D image.

How is vascular dementia treated?

There is no cure for vascular dementia and it’s not possible to reverse any damage that’s already happened, but treating any underlying causes can help to slow it down or stop it getting worse.

Medicines
Some medicines can help, for example, medicines to control blood pressure and stop blood clots from forming after a stroke or mini stroke. If you have Alzhiemer’s Disease as well, you might be offered medications for this.

Lifestyle
A healthy lifestyle with regular exercise, eating healthily, stopping smoking and cutting down on alcohol can help to keep your blood pressure down and help to slow down vascular dementia.

Living with vascular dementia

There is lots of support available to help people living with vascular dementia. For example, counselling and talking therapies can help you deal with the impact on your day to day life, and physiotherapy and support from an occupational therapist can help keep you independent.

It’s important to be social, stay active and do things you enjoy doing, including listening to music, art therapy, dancing, exercise. There are activities and services designed for people with dementia, for example, memory cafes, where you can meet people and get advice and support to deal with the day to day symptoms.

How can I lower my risk of vascular dementia?

Healthy lifestyle 
The best thing you can do to lower your risk of vascular dementia is lower your blood pressure, particularly in midlife.

The changes you can make to your lifestyle to lower your blood pressure, such as stopping smoking, being active and keeping to a healthy weight, will also help to lower your risk of diseases which affect the blood vessels, such as heart disease and stroke. This can lower your risk of developing vascular dementia.

Treatments for health problems
It’s important to get treatments for health problems you already have. For example, medications to lower blood pressure and stop blood clots from forming after a stroke or mini stroke, medications to lower blood cholesterol, and treatment for diabetes.

Visit your GP or get an NHS Health Check to help you and your GP to get an idea of your overall health, so you can get any treatment of support you need.

Read more 
Alzheimer's Society have information about vascular dementia as well as Alzheimer’s disease and other types of dementia, a helpline and an online talking community.

Dementia UK have a helpline and their Admiral Nurse service who can give one to one support for families facing dementia, as well as information on the different types of dementia.

NHS Choices have information about dementia and the different types of support available.

Click to print page