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A groundbreaking study led by the University of California, Irvine, has called into question long-standing assumptions about the impact of cardiovascular conditions on brain health in individuals aged 90 and older. The research, published in Alzheimer’s & Dementia, found that common cardiovascular risk factors such as high blood pressure and diabetes—known to damage blood vessels in the brain and increase the risk of cognitive decline in younger populations—do not appear to have the same detrimental effects on the brain in individuals over 90.
The study, which analyzed data from 267 participants in the National Institute on Aging’s 90+ Study, suggests that the relationship between blood pressure, vascular health, and brain aging is more intricate than previously believed. According to Dr. Ravi Rajmohan, the study’s corresponding author and a clinical instructor of neurology at UC Irvine, this research sheds new light on the effects of cardiovascular conditions in the elderly.
“For decades, we’ve known that high blood pressure and diabetes can injure blood vessels in the brain, contributing to cognitive decline and dementia. However, our research found that these associations may change as people age,” Dr. Rajmohan explained. “Even more compelling, we found that the use of blood pressure-lowering medications in this age group was linked to a lower likelihood of certain types of brain damage.”
The study’s findings challenge traditional views on vascular health and brain aging. Researchers applied statistical models that accounted for variables such as age, sex, and education, and found that brain changes in individuals aged 90 and older were not directly linked to typical cardiovascular risk factors like high blood pressure or diabetes.
Interestingly, the study also highlighted potential benefits of certain medications. Diuretics were associated with a lower likelihood of atherosclerosis, or “hardening of the arteries,” while beta blockers and vasodilators were linked to a reduced risk of cerebral amyloid angiopathy, a condition characterized by the buildup of proteins in brain blood vessels.
“Our findings suggest that traditional vascular risk factors may not be as harmful to brain health in individuals aged 90 and older as previously thought,” Dr. Rajmohan said. “It is possible that the effectiveness of treatments for these conditions or survival bias—where only individuals who have survived with these conditions live into their 90s—may be influencing these results.”
The study’s conclusions raise important questions about how blood pressure-lowering medications might directly affect brain blood vessel damage and dementia in elderly individuals. Dr. Rajmohan emphasized the need for further research to determine whether such treatments could offer more personalized guidance for managing blood pressure and improving brain health outcomes in older adults.
As the global population ages, understanding the complex relationship between cardiovascular health and brain aging is crucial for improving the quality of life for the elderly and developing more effective treatment strategies for age-related cognitive decline.
Source: Ravi Rajmohan et al, Vascular Risk Factors and Cerebrovascular Pathologic Changes on Autopsy: The 90+ Study, Alzheimer’s & Dementia (2025). DOI: 10.1002/alz.14454
