Nearly half of Americans today live with hypertension, or high blood pressure. According to 2024 data from the US Food & Drug Administration, more than 119 million adults have the condition—yet only one in four has it under control. Many assume hypertension is harmless until numbers rise, but new research shows otherwise.
A groundbreaking study from Weill Cornell Medicine, published in Neuron, reveals that hypertension begins harming the brain days before blood pressure levels actually increase.
Hypertension Affects the Brain Much Earlier Than Expected
The Weill Cornell research team discovered that hypertension disrupts the brain’s blood vessels, neurons, and white matter even before blood pressure readings go up. This early damage helps explain why high blood pressure is one of the strongest risk factors for cognitive disorders such as:
- Vascular cognitive impairment
- Alzheimer’s disease
The study also found that hypertension can trigger early gene expression changes in brain cells—changes that may impair thinking and memory. This could open new pathways toward treatments aimed at both lowering blood pressure and preventing cognitive decline.
Even though people with hypertension face a 1.2 to 1.5 times higher risk of cognitive disorders, the underlying cause has not been well understood. Many blood pressure medications effectively control hypertension but do little to protect the brain.
Dr. Costantino Iadecola, senior author of the study, explained:
“We found that the major cells responsible for cognitive impairment were affected just three days after inducing hypertension in mice—before blood pressure increased.”
What Happens Inside the Brain: Early Cellular Damage
To explore the earliest impacts of hypertension, researchers—co-led by Dr. Anthony Pacholko—used advanced single-cell technology to study mice models.
What they found just 3 days after hypertension onset (before BP increased):
- Major gene expression shifts in:
- Endothelial cells (blood vessel linings)
- Interneurons (control nerve signaling)
- Oligodendrocytes (maintain the myelin sheath)
- Signs of premature aging in endothelial cells:
- Reduced energy metabolism
- Elevated senescence markers
- Evidence of a weakened blood–brain barrier
- Early changes resembling Alzheimer’s pathology
By day 42, blood pressure had risen—and measurable cognitive decline had begun.
Dr. Pacholko noted:
“The extent of the early alterations induced by hypertension was quite surprising.”
How to Protect the Brain From Hypertension Damage
The team also tested losartan, a widely used blood pressure medication that blocks angiotensin receptors.
Losartan’s effects:
- Reversed early cellular damage in:
- Endothelial cells
- Interneurons
- Supported earlier research suggesting that angiotensin-receptor blockers (ARBs) may offer greater cognitive protection compared to other antihypertensive drugs.
Dr. Iadecola added that treating hypertension remains essential:
“Hypertension is a leading cause of damage to the heart and kidneys. So, independent of cognitive function, managing high blood pressure must be a priority.”
Important Note
This article is for educational purposes only. It is not a substitute for professional medical advice. Always consult a qualified healthcare provider before starting or changing any treatment, medication, or health routine.
Leslie Rajan