People who have fluctuating blood pressure in addition to high blood pressure are at increased risk for cerebrovascular disease, new research shows.

Cerebrovascular disease, which includes stroke and other disorders that affect the brain’s blood vessels, is associated with disability and a decline in memory and reasoning powers in older adults.

The new study included 686 dementia-free older adults who had their blood pressure measured during three study visits at 24-month intervals. The participants, who also underwent MRI to check for cerebrovascular disease, were divided into four groups depending on whether they had high or low blood pressure, and whether they had high or low blood pressure fluctuations between visits.

People with the lowest fluctuations had changes of about 5.5 percent (among those with low blood pressure) and 5.2 percent (among those with high blood pressure), while those with the highest fluctuations had changes of 14.2 percent, the study authors noted.

High blood pressure and fluctuations in blood pressure were both independently associated with increased risk of cerebrovascular disease. But people with both factors were at even greater risk, according to study author Adam M. Brickman, of the Taub Institute at Columbia University in New York City, and colleagues.

The researchers also found that participants with the highest blood pressure and fluctuation levels were most likely to be prescribed blood pressure-lowering drugs. This suggests that failure to adhere to treatment may be a source of blood pressure fluctuation.

“Cerebrovascular disease is associated with a constellation of conditions that lead to disability, including cognitive impairment, mood and movement disorders,” the researchers concluded. The new findings, they stated, suggest that managing blood pressure fluctuations, even in older adults with normal blood pressure, “may be beneficial in reducing the risk of cerebrovascular disease and in maximizing healthy cognitive aging.”

The study is published in the May issue of the journal Archives of Neurology.