A new study led by researchers at Wake Forest University School of Medicine has found that a few years of aggressive blood pressure management can significantly reduce the risk of mild cognitive impairment or dementia, even years after stopping the treatment.
This discovery highlights the long-lasting benefits of intensive blood pressure control in older adults with hypertension and high cardiovascular risk.
The study, published in Neurology, builds on the findings of the Systolic Blood Pressure Intervention Trial (SPRINT) and its cognitive sub-study, SPRINT MIND. Supported by the National Institutes of Health, SPRINT MIND examined 9,361 participants aged 50 and older across over 100 clinics in the United States and Puerto Rico.
Participants were randomly assigned to one of two systolic blood pressure goals: less than 120 mm Hg (intensive treatment) or less than 140 mm Hg (standard treatment).
Participants were monitored for a median of seven years, undergoing cognitive assessments in person or by phone. Based on these evaluations, participants were categorized as having no cognitive impairment, mild cognitive impairment, or probable dementia.
The study’s findings showed that the group receiving intensive blood pressure treatment experienced a significantly lower rate of cognitive impairment compared to the standard treatment group.
Specifically, these individuals had a reduced risk of mild cognitive impairment and a combined lower risk of either mild cognitive impairment or probable dementia.
This research builds on earlier findings from the landmark SPRINT trial in 2015, which demonstrated that intensive blood pressure management reduced cardiovascular disease and lowered the risk of death by 30–40% in people with hypertension.
The trial was stopped early due to its success in reducing cardiovascular events, meaning participants received intensive treatment for a shorter time than initially planned. This limitation made it difficult at the time to determine the impact of intensive blood pressure control on preventing dementia.
In 2019, initial results from SPRINT MIND revealed that three years of intensive blood pressure control significantly reduced the risk of mild cognitive impairment for up to five years after the treatment ended.
The latest findings now extend this timeline to at least seven years, reinforcing the long-term cognitive benefits of aggressive blood pressure management.
Dr. David M. Reboussin, a professor at Wake Forest University School of Medicine and the study’s corresponding author, emphasized the importance of these findings.
“We found that the intensive treatment group had a sustained lower incidence of developing cognitive impairment compared to those in the standard treatment group,” he explained.
Dr. Jeff Williamson, another senior researcher on the study, noted the practical implications for older adults. “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,” he said.
“Lowering your blood pressure to more aggressive targets can improve quality of life and extend active life for individuals with hypertension.”
The study underscores the potential of intensive blood pressure management as a preventative measure against cognitive decline, a condition that can profoundly impact independence and quality of life in older adults.
These findings suggest that healthcare providers should consider more aggressive blood pressure targets for patients at risk of cognitive decline, alongside other benefits like reduced cardiovascular risks. However, it’s also essential to monitor patients closely to ensure these interventions are safe and effective for individual needs.
By demonstrating the lasting cognitive benefits of just a few years of intensive treatment, this research offers hope for maintaining brain health in aging populations.
It also highlights the interconnected nature of cardiovascular and cognitive health, suggesting that proactive management of blood pressure could play a critical role in preserving cognitive function later in life.
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The research findings can be found in Neurology.
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