A recent study conducted by researchers at Wake Forest University School of Medicine has revealed that just over three years of intensive blood pressure management can continue to significantly reduce the risk of mild cognitive impairment or dementia for an extended period, even after the cessation of treatment in adults who have hypertension and are at high cardiovascular risk.
The results of this study were published online in ‘Neurology’, the medical journal of the American Academy of Neurology. These findings underscore the long-term advantages of aggressive blood pressure control strategies in staving off cognitive deterioration. The research was supported by the National Institutes of Health and forms part of the Systolic Blood Pressure Intervention Trial (SPRINT) Memory and Cognition in Decreased Hypertension (SPRINT MIND) study, which included 9,361 participants aged 50 years or older from over 100 clinic sites across the United States and Puerto Rico. Participants were randomly assigned to one of two groups: one with a systolic blood pressure goal of less than 120 mm Hg (intensive treatment) and the other with a goal of less than 140 mm Hg (standard treatment).
Over a median follow-up period of seven years, participants underwent cognitive assessments in person and via telephone. They were subsequently classified as having no cognitive impairment, mild cognitive impairment, or probable dementia. David M. Reboussin, PhD, professor of biostatistics and data science at Wake Forest University School of Medicine and the corresponding author of the study, noted that those in the intensive treatment group exhibited a consistently lower incidence of developing cognitive impairment than those receiving standard treatment.
The research team specifically observed that participants receiving intensive treatment had a lower rate of mild cognitive impairment and a lower combined rate of mild cognitive impairment or probable dementia. This pivotal observation highlights the effectiveness of maintaining lower blood pressure targets for extended mental health benefits.
The groundbreaking SPRINT trial in 2015 demonstrated that intensive blood pressure management not only reduced cardiovascular disease but also lowered the risk of death by 30-40% among individuals with hypertension. The trial’s success in reducing cardiovascular risks led to its early termination. This meant that participants were under intensive blood pressure-lowering treatment for less time than originally intended, which initially made it challenging to accurately assess the impact of intensive blood pressure control on dementia cases.
However, initial findings from the SPRINT MIND study in 2019, led by the same institution, showed a significantly reduced risk of developing mild cognitive impairment up to five years following the initial intensive control period of 3.3 years. These latest findings from the SPRINT MIND study reaffirmed the previously observed significant reductions in rates of cognitive impairment, now observed over a more extended period—at least seven years. Jeff Williamson, M.D., M.H.S., professor of gerontology and geriatric medicine at Wake Forest University School of Medicine, emphasized the importance of this study’s results. He highlighted that intensive blood pressure control is a crucial strategy in preventing cognitive impairment, a primary cause of loss of independence among older adults. By lowering blood pressure to more aggressive targets, individuals with hypertension can improve their quality of life and prolong their active years.
More information: David M. Reboussin et al, Long-Term Effect of Intensive vs Standard Blood Pressure Control on Mild Cognitive Impairment and Probable Dementia in SPRINT, Neurology. DOI: 10.1212/WNL.0000000000213334
Journal information: Neurology Provided by Atrium Health Wake Forest Baptist
