Dementia Risk Is Not Affected by BP Control Intensity
Intensively controlling blood pressure (BP) in a patient with hypertension does not reduce the risk for dementia, according to a new study. However, it can significantly reduce the risk for mild cognitive impairment and the combined rate of mild cognitive impairment or probable dementia.1
The determination comes from the final, peer-reviewed results of the Systolic Blood Pressure Intervention Trial Memory and Cognition in Decreased Hypertension (SPRINT MIND) study.
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To evaluate the effect of intensive BP control on dementia risk, the researchers randomly assigned 4678 participants to the intensive treatment group, in which they were instructed to meet a systolic BP goal of less than 120 mm Hg, and 4683 participants to the standard treatment group, where they had to meet a goal of 140 mm Hg.
The participants, who were aged 50 years or older and had hypertension but not diabetes or history of stroke, were from 102 sites across the United States and Puerto Rico.
The trial began on November 8, 2010, ended on August 20, 2015, and had a final date of follow-up for cognitive outcomes on July 22, 2018. Of all the participants, 8563 completed at least 1 follow-up assessment.
Adjudicated probable dementia occurred in 149 participants in the intensive treatment group and in 176 participants in the standard treatment group (a rate of probable dementia of 7.2 vs 8.6 cases per 1000 person-years). The difference was not statistically significant.
At the same time, intensive BP control significantly reduced the risk of mild cognitive impairment (14.6 vs 18.3 cases per 1000 person-years) and the combined rate of mild cognitive impairment or probable dementia (20.2 vs 24.1 cases per 1000 person-years).
“This study is in line with where the field of dementia research is going: preventing memory loss earlier,” said Laurie Ryan, PhD, program lead for SPRINT MIND. “Much like we have research-based interventions for heart health and cancer prevention, we hope to have guidance based on this and subsequent studies that will more definitively show how to slow or even stop dementia well before symptoms appear.”2
—Colleen Murphy
References:
1. Williamson JD, Pajewski NM, Auchus AP, et al; SPRINT MIND Investigators for the SPRINT Research Group. Effect of intensive vs standard blood pressure control on probable dementia: a randomized clinical trial [published online January 28, 2019]. JAMA. doi:10.1001/jama.2018.21442.
2. Does intensive blood pressure control reduce dementia? [press release]. Bethesda, MD: National Institutes of Health; January 28, 2019. https://www.nih.gov/news-events/news-releases/does-intensive-blood-pressure-control-reduce-dementia. Accessed January 29, 2019.