Intensive Blood Pressure Control Lowers Cognitive Impairment Risk Years Later
Just over 3 years of intensive treatment to reduce systolic blood pressure in adults with hypertension and high cardiovascular risk resulted in a lower rate of cognitive impairment 7 years later, according to a study published in Neurology.
“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 researcher Jeff Williamson, MD, MHS, professor of gerontology and geriatric medicine at Wake Forest University School of Medicine, Winston-Salem, North Carolina. “Lowering your blood pressure to more aggressive targets can improve the quality of life and extend active life for individuals with hypertension.”
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The findings resulted from a prespecified secondary analysis of the Systolic Blood Pressure Intervention Trial. Between 2010 and 2013, 9361 participants, aged 50 years and older, with hypertension and increased cardiovascular risk were randomly assigned to a systolic blood pressure goal of less than 120 mm Hg (intensive treatment) or less than 140 mm Hg (standard treatment). Participants, who were from a total 102 clinics in the United States and Puerto Rico, received treatment for 3.3 years.
Over a median 7 years of follow-up, patients underwent both in-person and phone-base cognitive assessments. The study ascertained the cognitive status of 4232 participants from the original trial, who were 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 first and corresponding author David Reboussin, PhD, professor of biostatistics and data science at Wake Forest University School of Medicine.
Specifically, 248 participants were categorized as having probable dementia in the intensive treatment group compared with 293 participants in the standard treatment group, according to the study. Per 1000 person-years, rates of probable dementia were 8.5 with intensive treatment and 10.2 with standard treatment.
Hazard ratios were 0.87 for developing mild cognitive impairment alone, and 0.89 for the composite outcome of mild cognitive impairment or probable dementia, with intensive treatment compared with standard treatment, the study found.
