How to Manage Hypertension With Early-Stage Alzheimer’s
Neurological DisordersAlzheimer’s Disease

How to Manage Hypertension With Early-Stage Alzheimer’s

How to Manage Hypertension With Early-Stage Alzheimer’s
Everyday Health
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Published on March 2, 2026
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Treatment for high blood pressure (hypertension) plays a vital role in brain health. Elevated pressure in your bloodstream wears down tiny blood vessels in your brain, increasing your risk of cognitive decline (poor brain function), dementia, and Alzheimer’s.

But when you’re managing hypertension and Alzheimer’s disease together, you may find it difficult to organize complicated medication schedules and remember to take pills, says Mill Etienne, MD, MPH, an associate professor of neurology and medicine at New York Medical College in Valhalla.

 Blood pressure medication side effects can also worsen confusion and increase your risk of falls, Dr. Etienne says.

Because of these risks, it’s important to talk to your healthcare provider about tools that can help, like simplifying your routine and involving a caregiver when needed.

Basics of Hypertension Management

When you have hypertension, your provider may recommend medication, diet changes, exercise, and home blood pressure monitoring.

 Some blood pressure medications relax your blood vessels, which eases the pressure inside, while others lower the amount of salt and fluid in your bloodstream or cause the heart to beat less forcefully.

Besides using prescribed medications, you can improve blood pressure by following the low-salt DASH diet, which experts believe works best for hypertension.

 Exercise also makes a big difference in blood pressure control. The American Heart Association recommends doing both aerobic exercise that increases your heart rate and resistance training, like lifting weights.

Challenges of Managing 2 Conditions

Living with both hypertension and Alzheimer’s can pose unique challenges. For example, between the two conditions, you may take several medications, and you might not remember what you already took that day, says George Wilmot, MD, PhD, a neurologist with Emory Healthcare in Atlanta and an assistant professor in the department of neurology at Emory University School of Medicine.

Forgetting to take your hypertension meds can lead to higher blood pressure, which can hasten cognitive decline.

 But too many doses can cause very low blood pressure, which can lower oxygen levels in your blood and increase your risk of falling.

Simplify Your Disease Management Routines and Stay Safe

You can manage Alzheimer’s with hypertension more easily by working with your provider to adjust your medications and routines.

Ask How to Simplify Your Medication Regimen

Keeping track of medications can get confusing quickly. “If you're even taking three or four medications, it gets to be overwhelming to keep track of them,” says Nicholas Doher, DO, a neurologist specializing in memory and cognitive disorders with Cleveland Clinic in Ohio. It’s easy to make mistakes, Dr. Doher says.

To simplify the medications you take and how you take them, ask your provider about these options:

  • Prepackaged medications prepared by your pharmacy
  • A pill organizer, which you can prefill with your caregiver
  • “Smart” pill dispensers, which can set alarms and record when medications are taken
Some pill organizers offer smartphone integration, says Dr. Wilmot. You can also ask your provider if any of your medications could be stopped, so you have fewer pills to take each day.

Discuss Your Blood Pressure Goals

When treating hypertension alongside Alzheimer’s, your target blood pressure may look different from standard goals or goals you may have had previously.

“Overly aggressive lowering may reduce blood flow to the brain from low blood pressure, worsen cognitive symptoms, and increase confusion,” says Etienne.

By shooting for a slightly higher blood pressure, you can lower your risk of hypotension and falls — but you should not change any aspect of your blood pressure control regimen without discussing it first with your provider.

Monitor Medication Side Effects

Keep an eye on any side effects and let your provider know if you experience them. Low blood pressure can cause symptoms like:

  • Fatigue
  • Confusion
  • Weakness
  • Lightheadedness
  • Dizziness and fainting
  • Head, neck, or back pain
  • Heart palpitations
  • Blurry vision
  • Nausea
Alzheimer’s doesn’t typically cause dizziness until later stages, but medications to treat it can cause this symptom and make you feel very tired.

 Some medications for Alzheimer’s can also cause tiny areas of bleeding in the brain, and hypertension can increase this risk, says Wilmot.

Check Your Blood Pressure at Home

A home blood pressure cuff can offer valuable insight and emotional relief when you aren’t sure how your body is responding to your medication. Doher recommends checking blood pressure at home once a week to twice a day, depending on your symptoms, recent medication changes, and what your provider tells you.

Don’t go overboard and check it every hour, says Doher. “Something like once or twice a day is — for the vast majority of people — going to be more than enough.”

Lifestyle Approaches That Can Help Both Blood Pressure and Brain Health

Besides medications and other treatments, you can try some lifestyle changes to enhance both hypertension and Alzheimer’s therapies. “Maintaining a heart-healthy lifestyle — including a balanced diet, gentle physical activity, adequate hydration, meditation, and good sleep — supports both blood pressure control and brain health,” says Etienne.

Follow the Best Diet for Brain and Heart Health

Doher recommends the MIND, Mediterranean, or a heart-healthy diet.

 Dietary choices that support both brain and heart health include:

  • Vegetables (with plenty of leafy greens)
  • A variety of fruits
  • White meat and fish (baked, broiled, or grilled)
  • Canola, corn, soybean, sunflower, and extra-virgin olive oils
  • Beans and nuts
  • Whole grains
These diets also recommend avoiding:

  • Processed foods
  • Added sugar
  • Salt
  • Alcohol
  • Fried foods
  • Saturated fats

Exercise 2 to 4 Times a Week

“Exercise is one of the best things that people can do,” says Doher. It can get blood pressure under better control, reduce anxiety and depression, and improve sleep quality, he says. “It actually may even have a direct impact on slowing the disease course of Alzheimer's.”

Moderate-intensity exercise and aerobic exercise that gets your heart pumping has these direct effects on the brain:

  • Less inflammation
  • Brain cell growth
  • Improved memory
When you compare recommendations for exercise for brain health and hypertension, experts suggest getting this much physical activity:

  • About 30 minutes of moderate-intensity aerobic exercise four times a week (fast walking, water aerobics, cycling on flat ground)
  • 15 to 20 minutes of strength training two times a week (lifting weights, push-ups, sit-ups)
  • 10 to 15 minutes of balance and stretching exercises two times per week.
According to the American Heart Association, you can replace this amount of moderate-intensity exercise with 75 minutes per week of vigorous exercise.

 This could look like three 25-minute runs or a few rounds of singles tennis each week.

Soothe Stress

Chronic conditions can bring plenty of stress, which can boost your blood pressure and make cognitive decline worse, so it’s important to find ways to manage it. For less stress, try these tips.

  • Do yoga, go swimming, or take a walk.
  • Practice meditation and mindfulness.
  • Write your feelings in a journal.
  • Listen to music you love.
  • Try an artistic activity.
  • Do deep-breathing exercises.
  • Spend time with friends and family.

Get Enough Sleep

Getting enough sleep helps your brain and heart stay healthy. Try to get at least seven hours of sleep each night.

 If you have trouble sleeping this much, tell your healthcare provider. They can check for sleep disorders like sleep apnea and recommend treatment.

The Takeaway

  • Managing hypertension and Alzheimer’s can pose several challenges; you may forget to take medications, take too many doses, and experience a higher risk of falling.
  • You can stay safe and simplify your treatment plan for both conditions by asking your provider about stopping unneeded medications, using pill organizers, monitoring side effects, and checking your blood pressure at home.
  • Lifestyle changes that boost brain and heart health include following the MIND or Mediterranean diets, exercising regularly, managing stress, and getting enough sleep.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Jones DW et al. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Hypertension. August 14, 2025.
  2. Wei X et al. Hypertension and Alzheimer’s Disease: Pathological Interplay, Comorbidity Risks, and New Strategies for Synergistic Management. Clinical and Experimental Hypertension. December 31, 2025.
  3. What Are the Signs of Alzheimer's Disease? National Institute on Aging. October 18, 2022.
  4. How Do Blood Pressure Medications Work? University Hospitals. July 18, 2022.
  5. DASH Eating Plan. National Heart, Lung, and Blood Institute. January 10, 2025.
  6. Getting Active to Control High Blood Pressure. American Heart Association. August 14, 2025.
  7. Yan S-C et al. Effects of Hypertension on Alzheimer's Disease: Updates in Pathophysiological and Neuroimaging Findings. Journal of Integrative Neuroscience. August 12, 2024.
  8. Medications That Increase Your Risk of Falling. Harvard Health Publishing. November 15, 2021.
  9. Low Blood Pressure (Hypotension). Mayo Clinic. June 13, 2024.
  10. Taking Medications With Dementia. Alzheimer's Society.
  11. Medical Management. Alzheimer's Association.
  12. Wiersinga J et al. Hypertension and Orthostatic Hypotension in the Elderly: A Challenging Balance. The Lancet Regional Health - Europe. December 3, 2024.
  13. Low Blood Pressure. National Heart, Lung, and Blood Institute. March 24, 2022.
  14. Na S et al. Dizziness and Neuro-Otologic Findings in Neurodegenerative Disorders: A Review. Research in Vestibular Science. June 15, 2025.
  15. Dementia Medication Side Effects. Alzheimer's Society.
  16. Eat Right. Alzheimer's Association.
  17. The American Heart Association Diet and Lifestyle Recommendations. American Heart Association. July 30, 2024.
  18. Pahlavani HA. Exercise Therapy to Prevent and Treat Alzheimer’s Disease. Frontiers in Aging Neuroscience. August 4, 2023.
  19. What Counts as Physical Activity for Adults. Centers for Disease Control and Prevention. December 6, 2023.
  20. Get Moving. Alzheimer's Association.
  21. Reducing Stress. Alzheimer's Association.
  22. Managing Stress to Control High Blood Pressure. American Heart Association. August 14, 2025.
  23. Why Is Sleep Important? National Heart, Lung, and Blood Institute. March 24, 2022.
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Cheng-Han Chen, MD, PhD, FACC, FSCAI

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Cheng-Han Chen, MD, PhD, is the medical director of the structural heart program at MemorialCare Saddleback Medical Center in Laguna Hills, California, and director of structural and interventional cardiology at Pacific Cardiovascular Associates Medical Group.

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