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"It's possible that by preventing or treating high blood pressure, we could potentially prevent cognitive impairment, which can be a precursor to dementia," Tsivgoulis said in a statement. But more research is needed to confirm that there is a relationship between high blood pressure and mental impairment, the statement said.

That thought was echoed in a statement by Dr. Walter J. Koroshetz, deputy director of the U.S. National Institute of Neurological Disorders and Stroke, which has supported the stroke study.

"The National Institutes of Health is now organizing a large clinical trial to evaluate whether aggressive blood pressure lowering can decrease a number of important health outcomes, including cognitive decline," the Koroshetz statement said.

Meanwhile, Howard said, the study shows one more reason why it is important to control high blood pressure.

The new study "supports a large body of literature that shows that hypertension, which almost always begins in mid-life, has an impact on cognition," said Dr. David Knopman, a professor of neurology at the Mayo Clinic in Rochester, Minn.

There are several reasons why some studies have not shown such an effect, Knopman said. "Some of the key differences reflect the age of the populations," he said. "If you have an older population, you have more people with hypotension, unusually low blood pressure, and the presence of them in the study wipes out the deleterious effects of hypertension. Also, the quality of care that the population has been receiving affects the results. If hypertension is treated effectively, you may not see an effect on cognition. It is difficult to know the quality of care in a study like this one."

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