Hidden dangers we need to monitor

You may have heard that we are in the era of ‘wearables’: devices we wear that can continuously monitor various aspects of our health.

I personally wear a ring that tracks my sleep and, periodically, a continuous glucose monitor (CGM): a small disc with a miniscule needle that sits under my skin and measures my blood sugar levels at any given moment in time.

Though these devices have their limitations, they can be highly motivating.

I have tried (albeit with variable success) to address my insomnia by optimising my sleep hygiene and using certain supplements. With the CGM, I am much more aware of what foods spike my blood sugar (not a good thing) and have altered my diet accordingly.

The breadth of things these gadgets can monitor is expanding.

I recently met a scientist and entrepreneur who has designed a small device you put on the skin which measures your hydration status. There are many experts who believe that a large proportion of us are dehydrated and yet unaware.

Dehydration is not a good thing for your body or brain and is simple to fix.

I’m interested to see whether this product becomes popular and useful.

I also recently listened to a podcast featuring an American cardiologist who has designed a continuous blood pressure monitor that you wear on your wrist.

This was of considerable interest to me as someone dealing with brain health.

We know that a single snapshot of your blood pressure is not that helpful.

Visiting your doctor itself often elevates your blood pressure temporarily – so-called ‘white coat hypertension’ – potentially giving a false impression it is a problem otherwise.

This can lead to the inappropriate use of medications to reduce blood pressure, and this carries risk – chiefly by overdoing it and sending your blood pressure too low, causing faints and falls. Having a more consistent and longitudinal measure is therefore helpful.

One of the concerns about high blood pressure is that it is usually silent: that is, there are no symptoms. This means it could be running high for years or decades even, without you knowing.

This is a real problem, as chronically high blood pressure can cause myriad problems for the body.

You may not believe it, but high blood pressure is reckoned to be one of the leading causes of death worldwide, leading to strokes and heart attacks, as well as kidney damage.

Long-term high blood pressure is also a risk factor for dementia.

There are various reasons for this, including the increased risk of stroke and small blood vessel disease in the brain (a very common cause of dementia) and the breakdown of the blood-brain barrier.

This is a very thin but crucial layer between the blood vessels and the  brain tissue.

When it works well, it prevents the ingress of toxins and inflammatory molecules into the brain.

When it is damaged, including by  high blood pressure, this protective element is lost.

Chronically high blood pressure  can also lead to reduced brain volume, which again is not a good thing. Most of us (including me) are not wearing these blood pressure monitors, but we should still check our pressure regularly.

Repeated tests at the doctor (not just a one-off) may be helpful.

Alternatively, using a traditional blood pressure monitor at home (you can buy them cheaply from most chemists) and measuring your blood pressure over a week or so can be illuminating.

The results should then be discussed with your doctor.

I am always looking for the low-hanging fruit when it comes to reducing the risk of dementia, and high blood pressure is ripe for the picking.

 Kailas Roberts is a psychogeriatrician and author of Mind Your Brain: The Essential Australian Guide to Dementia, available at bookstores and online. Visit yourbraininmind.com or uqp.com.au