Many patients come to A&E not because they’ve had an accident or an emergency, but in despair, unsure of where else to go. A couple of months ago I saw a gentleman in his late-60s typical of this sad situation.

He didn’t arrive shouting or gasping or bleeding, as you might expect in casualty: he was polite, softly spoken and looked fit and healthy. If anything, it was his wife who did most of the talking.

‘We shouldn’t be here,’ she told me, holding back tears.

‘I just don’t know what to do. I can’t cope any more. It’s not safe at home any more. He leaves the oven on and wanders out of the house and forgets things. He’s not the man he was even a few months ago.’

Indeed, until a few months ago this gentleman had never been to the doctor. He’d lived a healthy life; exercised frequently, ate well, was a non-smoker and drank alcohol only socially at weekends. He had worked as the IT director of a high-profile pharmaceutical company until retiring three years ago, ready to live a wonderful next 20 years, travelling, socialising and helping bring up his five grandchildren.

I arranged for a scan of his head because he’d had a fall a few days ago, and to check if there was a bleed causing his confusion.

His scan later showed brain shrinkage – but no injury: clear signs of dementia. Other tests ruled out other causes of confusion, such as a urinary tract infection.

I explained to his distressed wife that he had dementia and there was nothing we could do to reverse what had happened.

The only thing that stood out in his medical history was that his blood pressure had been ‘a little high’.

And this has implications for many of us, as we might want to get our blood pressure even lower than most GPs currently advise – and even think about a couple of specific supplements.

For the past 20 years this man’s systolic pressure (the top number, the pressure in your blood vessels when your heart contracts) had hovered in the 140s, never enough to sound alarm bells, but following a routine blood pressure check at work (when his reading was 150/92) – he’d always relied on lifestyle changes (losing weight, exercising and cutting down on salt), to get his blood pressure down.

It had worked to an extent and his blood pressure had come down to the 140s, which he and his GP were happy enough with.

But although not technically high, it certainly wasn’t optimal.

For years we’ve known that high blood pressure is bad for your health. It increases your risk of heart attacks, strokes and kidney failure.

And now it’s increasingly clear that high blood pressure is also a major cause of dementia – especially when raised blood pressure is left untreated in midlife.

A 2023 study published in JAMA Network Open analysed data from more than 34,000 adults and showed that individuals with untreated high blood pressure (known as hypertension) had a 42 per cent higher risk of developing dementia, compared to those with normal blood pressure.

Another important study that year showed what’s going on.

Brain scans revealed that even small increases in blood pressure above optimal (120/80) from young adulthood are linked to premature brain ageing.

In the study, published in the journal Alzheimer’s & Dementia, researchers tracked more than 600 people from their early 20s into their 50s. They found that for every five-point increase in systolic blood pressure, brain scans looked around a year older — meaning someone with readings in the 140s could have a brain that appears five years older than someone with optimal blood pressure of 120/80.

But the real turning point in our understanding of blood pressure and dementia is in a study published a few weeks ago.

When people aged 50 and above with high blood pressure were divided into two groups – either having normal treatment to get their systolic blood pressure down to 140 or lower, or given intensive treatment (stronger doses or additional tablets) to get it to 120 - the intensive treatment group were 11 per cent less likely to develop mild cognitive impairment or probable dementia over the next seven years.

This to me is compelling and quite frankly scary data.

What you do for your blood pressure and your brain health in your 40s to 60s determines your quality of life in your later years.

It doesn’t even have to be the kind of blood pressure that sends GPs scrambling for prescription pads.

In fact the National Institute for Health and Care Excellence recommends that blood pressure should be below 140/90 in those under the age of 80.

But this is based on what’s cost effective within NHS resources. And as an individual, I want what’s best for me - and not what’s most cost effective for the population. That’s where we need to take control of our own health.

I’ve bought a blood pressure monitor, which I use about once a month to monitor my readings.

My latest blood pressure is 124/82 and so I don’t need to consider medication.

But after reading these studies I would now look to getting it treated when it started hitting the 130s (and not 140 like I used to think). I’ve actually been there before - a few years ago, prior to thinking much about my health, my blood pressure was in the 130s.

I changed my lifestyle - lost weight, cut out junk food, reduced salt intake and exercised most days - which has made a big difference.

But I also looked at what natural supplements could make a difference – backed up by scientific data.

A study published in the journal Frontiers in Nutrition in 2022 found that beetroot can help lower blood pressure. And not just a little.

The researchers pulled together the results from seven good-quality randomised trials - their analysis showed that eating beetroot daily or taking a daily beetroot supplement caused nearly a five-point drop in systolic blood pressure.

That’s potentially enough to meaningfully reduce your risk of dementia, as well as strokes and heart attacks.

The likely hero is nitrate, a natural plant compound that your body turns into nitric oxide - a chemical that relaxes your blood vessels and improves flow. Simple. Effective. Natural.

There is also great data for garlic extract. The Cochrane Collaboration (basically the nerds of the medical research world - in a good way) did a review in 2012 that found that garlic supplements could reduce systolic blood pressure by around 10 to 12 points. That’s on a par with some prescription medications.

The secret is in how garlic boosts nitric oxide and relaxes blood vessels, working in a similar way to beetroot.

The only issue with garlic is that back then the studies were small, so Cochrane said we needed more data to be absolutely sure.

Fast forward, and newer research - including a 2020 review of studies - has filled in the gaps. One trial found that taking aged garlic extract brought systolic blood pressure down by 8 to 10 points in people with hypertension.

That’s why I take both supplements, with the aim of keeping my blood pressure as close as possible to 120/80, to dial down my odds of getting dementia and being like my patient.

It’s too late to make a difference if you only treat high blood pressure when you are in your late 70s and 80s. It is what we do much earlier in life that’s important.

The best time to check your blood pressure was yesterday. The next best time is today.