Intensive blood pressure control contributes to a significant reduction of the risk of mild cognitive impairment or dementia, even long after stopping the treatment in adults with hypertension and high cardiovascular risk, a new study has shown.
The findings highlight the sustained benefits of aggressive blood pressure management in preventing cognitive decline.
The study involved 9,361 participants aged 50 years and older at more than 100 clinic sites in the United States and Puerto Rico. Participants were randomly assigned to a systolic blood pressure goal of either less than 120 mm Hg (intensive treatment) or less than 140 mm Hg (standard treatment).
Participants were followed for a median of seven years, with cognitive assessments conducted both in-person and via telephone. Participants were then classified as having no cognitive impairment, mild cognitive impairment or probable dementia.
“We found that the intensive treatment group had a sustained lower incidence of developing cognitive impairment compared to those in the standard treatment group,” said David Reboussin, professor of biostatistics and data science at Wake Forest University School of Medicine and the study’s corresponding author.
Researchers specifically found that participants in the intensive treatment group had a lower rate of mild cognitive impairment and a lower combined rate of mild cognitive impairment or probable dementia.
In 2015, published findings from the landmark SPRINT trial showed that intensive blood pressure management reduced cardiovascular disease and lowered the risk of death by 30 to 40per cent in persons with hypertension.
SPRINT was stopped early due to the success of the trial in reducing cardiovascular disease. As a result, participants were on intensive blood pressure lowering treatment for a shorter period than originally planned.
The authors at that time concluded that the shorter time made it difficult to accurately determine the role of intensive blood pressure control in dementia cases.
Five years later, in 2019, initial results of SPRINT MIND, led by Wake Forest University School of Medicine, showed that there was a significantly reduced risk of developing mild cognitive impairment for up to five years following the initial 3.3 years of intensive blood pressure control.
These latest SPRINT MIND findings showed the same previously observed significant reduction in cognitive impairment rates, but over a longer period—at least seven years.
“Our study shows that intensive blood pressure control is an important strategy in the prevention of cognitive impairment, a major cause of loss of independence in older adults,” said Jeff Williamson, professor of gerontology and geriatric medicine at Wake Forest University School of Medicine.
“Lowering your blood pressure to more aggressive targets can improve the quality of life and extend active life for individuals with hypertension.”
