Intensive Blood Pressure Tx Does Not Reduce Dementia Risk
But drop seen in risk for MCI and combined rate of cognitive impairment, probable dementia
(HealthDay News) -- Treating systolic blood pressure (BP) to a goal of less than 120 mm Hg rather than 140 mm Hg does not result in a significant reduction in the risk for probable dementia, according to a study published online in the Journal of the American Medical Association.
Jeff D. Williamson, MD, MHS, from the Wake Forest School of Medicine in Winston-Salem, North Carolina, and colleagues randomly assigned adults aged 50 years or older with hypertension to a systolic BP goal of <120 mm Hg (4678 participants) or <140 mm Hg (4683 participants).
The trial was stopped early for benefit on its primary outcome (a composite of cardiovascular events) and all-cause mortality. The researchers found that adjudicated probable dementia occurred in 149 and 176 participants in the intensive and standard treatment groups, respectively, during a median follow-up of 5.11 years (7.2 vs 8.6 cases per 1000 person-years; hazard ratio, 0.83; 95% confidence interval, 0.67 to 1.04). With intensive BP control, significant reductions were seen in the risk for mild cognitive impairment (14.6 vs 18.3 cases per 1000 person-years; hazard ratio, 0.81; 95% confidence interval, 0.69 to 0.95) and in the combined rate of mild cognitive impairment and probable dementia (20.2 vs 24.1 cases per 1000 person-years; hazard ratio, 0.85; 95% confidence interval, 0.74 to 0.97).
"These results importantly show that intensive BP control did not result in harm to cognition," the authors write. "Moreover, there is some indication that intensive BP control may be beneficial."
Several authors disclosed financial ties to pharmaceutical companies, including Takeda Pharmaceuticals, which provided study medications.
The SPRINT MIND Investigators for the SPRINT Research Group. Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia: A Randomized Clinical Trial.
JAMA. DOI:10.1001/jama.2018.21442. (Published online January 28, 2019)
Yaffe K. Prevention of Cognitive Impairment With Intensive Systolic Blood Pressure Control. JAMA. DOI:10.1001/jama.2019.0008 (Published online January 28, 2019)