Diabetes Complications

High rate of type 2 diabetes and high blood pressure associated with brain changes

The high rate of combined type 2 d diabetes and high blood pressure in Puerto Ricans may be associated with structural changes in the brain, recent study says.

Study author Bang-Bon Koo PhD, of Boston University in Massachusetts, said: “This high prevalence of people who have both diabetes and high blood pressure may be a key factor contributing to health disparities in cognitive impairment in Puerto Rican people compared to white people of the same age range.

“This research is important because although Hispanic people make up more than 18 per cent of the U.S. population, they are underrepresented in large studies on the prevalence of diseases and have usually been treated as a whole group instead of looking at smaller groups from different backgrounds such as Puerto Ricans, Cubans or Mexican Americans.”

192 Puerto Rican people from the Boston area were studied for more than 10 years. Throughout the years, they had brain scans and took thinking skills tests.

The participants were put into four groups depending on if they had type 2 diabetes and high blood pressure. 54 had neither, 67 had high blood pressure without diabetes, and 61 people had both. The 10 people with type 2 diabetes without high blood pressure were not included in the study due to low numbers.

The results were compared to the results from two larger studies which included Hispanic and white people.

The findings displayed that around five times as many Puerto Rican people had diabetes compared to white people (32 per cent compared to seven per cent). Significantly more Puerto Rican people had high blood pressure compared to white people (67 per cent compared to 39 per cent).

The results also revealed that Puerto Rican people with both conditions had the smallest volume in the hippocampal area of the brain. This area of the brain plays a role in learning and memory and is affected by Alzheimer’s disease.

Participants with type 2 diabetes and high blood pressure also presented clear patterns of deterioration in the white matter of the brain compared to the people with neither condition. People with just high blood pressure presented less deterioration.

People with both conditions also showed a greater difference between their actual age and estimated “brain age”. This demonstrates that aging is affecting their brain more than it is in people who did not have both conditions.

Results were modified for factors including age, sex, and education level.

Dr Koo explained: “The decline in brain health and cognitive capacity in people in the Puerto Rican study who had both diabetes and high blood pressure was comparable to people in another study who had mild cognitive impairment and progressed to Alzheimer’s disease within five years.

“Our results suggest that the high rate of diabetes and high blood pressure among Puerto Rican people may contribute to the higher risk of Alzheimer’s disease within this group.”

The study, supported by the National Institutes of Health and the Department of Defense, was published in the journal Neurology.

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