# Can Untreated Hypertension Cause Dementia?
Yes, untreated high blood pressure significantly increases your risk of developing dementia. People with uncontrolled hypertension are 42 percent more likely to get dementia compared to those who manage their blood pressure through treatment. This connection is particularly strong when high blood pressure develops during midlife, between ages 45 and 64, which appears to be the most critical period for future dementia risk.
## How High Blood Pressure Damages the Brain
Untreated hypertension damages your brain through several different pathways. Chronic high blood pressure causes damage to small blood vessels in the brain, leading to white matter lesions and brain tissue shrinkage. This damage disrupts the normal flow of blood to your brain, which is essential for keeping your brain cells healthy and functioning properly.
Beyond blood vessel damage, high blood pressure creates oxidative stress in your brain, which accelerates the breakdown of brain cells. It also triggers inflammatory processes throughout your body that contribute to both vascular dementia and Alzheimer’s disease. These multiple mechanisms working together make untreated hypertension a serious threat to your cognitive health.
## Why Midlife Matters Most
The timing of when you develop high blood pressure matters significantly. Hypertension that starts in midlife poses the greatest risk for future dementia. Research shows consistent associations between midlife high blood pressure and cognitive decline later in life. In contrast, high blood pressure that develops later in life, after age 65, shows a weaker connection to dementia risk. This means that controlling your blood pressure during your 40s and 50s is particularly important for protecting your brain health.
## The Good News About Treatment
The encouraging finding from recent research is that treating high blood pressure actually reduces your dementia risk. A major study published in Nature Medicine involved nearly 34,000 adults in rural China with uncontrolled high blood pressure. Half of the participants received intensive blood pressure management through community health professionals, while the other half received standard care. Over 48 months, the group receiving intensive treatment achieved blood pressure levels lower than 130/80 mm Hg and were notably less likely to develop dementia compared to the standard care group.
This research demonstrates that it is never too late to benefit from controlling your blood pressure. The key is achieving actual blood pressure control rather than taking any specific medication. Current treatment guidelines recommend that doctors focus on helping patients reach their blood pressure targets, as the dementia prevention benefit comes from the control itself.
## Who Is Most at Risk
While high blood pressure increases dementia risk for many people, certain groups face additional challenges. People living in socioeconomically disadvantaged areas often have higher rates of uncontrolled hypertension due to social and environmental stressors. These same communities also show lower cognitive function across multiple areas including memory, attention, and language skills. This suggests that addressing high blood pressure is especially important in communities facing economic hardship.
Additionally, some ethnic groups including Black African and Caribbean communities and South Asian communities have higher rates of high blood pressure, which may increase their dementia risk if left untreated.
## What You Can Do
Managing your blood pressure is one of the most accessible ways to reduce your dementia risk. If you have high blood pressure, work with your doctor to achieve and maintain healthy blood pressure levels. This is particularly important if you are in your 40s and 50s, as controlling blood pressure during midlife appears to offer the greatest protection against future cognitive decline.
A healthy lifestyle also supports blood pressure control and brain health. This includes maintaining a healthy diet, staying physically active, managing stress, and avoiding excessive alcohol consumption. Taking control of modifiable risk factors like high blood pressure now can significantly protect your brain health and reduce your risk of dementia, stroke, and other serious conditions later in life.
## Sources
https://www.droracle.ai/articles/644255/can-hypertension-htn-cause-dementia
https://pmc.ncbi.nlm.nih.gov/articles/PMC12725286/
https://www.heart.org/en/around-the-aha/heart-association-highlights-2025s-major-research-findings
https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.71002?af=R
https://pubmed.ncbi.nlm.nih.gov/41362151/?fc=None&ff=20251212214111&v=2.18.0.post22+67771e2