Scientists have found that lowering blood pressure appeared to reduce the risk for cognitive decline in people 50 and older with high blood pressure.
But it has been unclear whether the strategy was safe or effective in people whose diastolic blood pressure – the bottom number in a blood pressure reading – was low.
In a study from China, scientists found no evidence that intensive systolic (top number) blood pressure control is harmful to people whose diastolic blood pressure is low.
They found that compared to people whose systolic blood pressure was lowered to standard levels, people who intensively reduced their systolic levels had a lower risk for probable dementia or mild cognitive impairment, regardless of whether their diastolic levels were high or low before treatment.
A blood pressure reading has two numbers. The top number measures systolic pressure, the force against artery walls when the heart beats.
The bottom number, diastolic pressure, measures the same force between beats.
In this study, researchers used data from people 50 and older with high systolic blood pressure to an intensive blood pressure control target (less than 120 mmHg) or a standard one (less than 140 mmHg).
Cognitive function was measured using a series of tests at the start and throughout the course of follow-up.
The researchers looked at whether intensive control could harm cognitive function in people with very low diastolic blood pressure.
They showed people with the lowest diastolic pressure levels had higher rates of cognitive decline than those with higher diastolic pressure.
However, regardless of diastolic pressure, people in the intensive blood pressure-lowering group had lower risks of probable dementia or mild cognitive impairment than those in the standard group.
There was no evidence that intensive blood pressure control harmed cerebral blood flow.
The findings suggest there may be a greater cognitive benefit to intensive blood pressure control for people with very high diastolic pressure, compared to those with very low diastolic levels, Gottesman said.
The researchers noted that those in the lowest diastolic group were more likely to be older and have more health problems.
It’s also possible that people in the low diastolic group were already in the early stages of dementia.
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The study was published in Hypertension.
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