This NPR report built around exhortations to control blood pressure by the head of a federal health agency draws attention to the long-documented links between hypertension and some forms of dementia.
For many, many reasons, diagnosing and treating high blood pressure are good ideas for maintaining health and preventing strokes and heart disease, and the better news is that there are dozens of drugs and lifestyle changes available — some of them very inexpensive — to help people do so.
But this story doesn’t explain that the evidence for an association between high blood pressure and vascular dementia, much less Alzheimer’s disease, is so far mostly observational. And perhaps more significantly, the story carries no data at all to support even the claims or strengths/weaknesses of the association.
This NPR story missed an opportunity to offer the data and help the public understand more about risk assessment and probabilities of disease related to blood pressure. And it may mislead people into thinking that if they pop a pressure pill each day, they will avoid Alzheimer’s Disease. That’s unproven.
No specific brand name interventions mentioned, though it’s implied that medication is frequently used.
While we wouldn’t expect the story to list the prices of the many drugs for high blood pressure, we do think the story could have discussed this aspect of seeking treatment. Is it a factor in why so many people don’t treat their high blood pressure?
The story makes several references to “greatly magnified” and an “increase” in risk of AD or vascular dementia among those with high blood pressure that goes untreated, but there are no solid data offered to support the claim, nor how treating blood pressure reduces that risk (and to what extent).
As with costs, we wouldn’t expect a story like this to cover all the side effects of the myriad treatments.
But we do think it could have noted that one reason blood pressure drugs are prescription-only is because they can cause side effects that may need medical management. Unlike what the story said, it is not as simple and carefree as taking “a pill… to help keep [your] brain healthy and sharp.”
The story, as noted earlier, is based on comments from the director of the National Institute of Neurological Disorders and Stroke. The story does not say anything about the nature or quality of the evidence on which the advice is based, or make clear that the last word is far from written about the causes of Alzheimer’s Disease and other dementias.
The story strongly suggets that people should take blood pressure medication to lower their risk of dementia. The evidence in the story wasn’t strong enough to cross that line.
At the very least, the story should have provided links to the studies in this sentence: “At least two large studies have revealed an alarming trend among stroke patients.”
It’s also worth noting that the threshold for treatment is under debate, with some saying that blood pressure should be even lower than 130/80. New suggestions like this — that BP control can lower dementia risk — may amplify such concerns by driving even more people in for treatment without a full grasp of the tradeoffs between potential benefits and potential harms.
The story quotes an official of the Alzheimer’s Association, which has an obvious interest in the prevention and treatment of AD. But NPR would have added much credibility to the story with some cautionary note from outside sources about the nature of the evidence for blood pressure control and AD prevention.
The story indirectly discusses alternatives–such as exercise and diet.
It’s clear in the story that blood pressure medications and lifestyle changes are readily available.
The story makes it clear that the news “hook” is new research to be presented at the Alzheimer’s Association meeting. (Why not wait for that, to make this story meatier?)
The Alzheimer’s Association website is promoting its upcoming July annual meeting, but there was no news release specifically addressing the content of this story.