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Intensive BP Control Linked to Long-Term Cognitive Benefits

Medically reviewed by Carmen Pope, BPharm. Last updated on Jan 28, 2025.

By Elana Gotkine HealthDay Reporter

TUESDAY, Jan. 28, 2025 -- In an extended follow-up study, intensive blood pressure control is associated with reductions in the rate of cognitive impairment, according to a study published in the Feb. 11 issue of Neurology.

David M. Reboussin, Ph.D., from Wake Forest University School of Medicine in Winston-Salem, North Carolina, and colleagues conducted a prespecified analysis of a randomized clinical trial (the Systolic Blood Pressure Intervention Trial [SPRINT]) to estimate the effect of intensive versus standard systolic blood pressure (SBP) lowering on the longer-term incidence of cognitive impairment. Patients aged 50 years and older with hypertension and increased cardiovascular risk were recruited between 2010 and 2013 and were randomly assigned to an SBP goal of <120 or <140 mm Hg (intensive or standard treatment, respectively) and treated for 3.3 years.

Overall, 7,221 of the 9,361 randomized participants were eligible to be recontacted. The cognitive status of 4,232 participants was ascertained. The researchers found that during a median follow-up of seven years, 248 and 293 participants in the intensive and standard treatment groups were adjudicated with probable dementia (8.5 versus 10.2 per 1,000 person-years; hazard ratio, 0.86; 95 percent confidence interval [CI], 0.72 to 1.02). The rates of both mild cognitive impairment (MCI) and a composite of MCI or probable dementia were lower with intensive treatment, consistent with earlier results from the trial (hazard ratios, 0.87 [95 percent CI, 0.76 to 1.00] and 0.89 [95 percent CI, 0.79 to 0.99], respectively).

"Over a median of almost seven years of follow-up, we observed that the previously reported statistically significant reduction in the rate of cognitive impairment (composite of MCI or probable dementia) was maintained," the authors write.

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Posted January 2025

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