Dementia is now the fifth leading cause of death worldwide, placing a heavy burden on families, healthcare systems, and economies.
As there are still no cures for dementia, preventing it—especially by managing known risk factors—has become a top public health goal.
One major risk factor is high blood pressure, but until now, there hasn’t been enough strong evidence to show that reducing blood pressure can actually prevent dementia. A groundbreaking new study may change that.
Researchers from several universities in China have conducted one of the largest and most detailed trials ever focused on this question.
Called the China Rural Hypertension Control Project Phase-3 (CRHCP-3), the study followed nearly 34,000 adults from 326 rural villages in China for four years.
The goal was to find out whether more intensive blood pressure control could reduce the risk of developing dementia or cognitive problems in people with high blood pressure.
Published in Nature Medicine in April 2025, the study involved 17,407 people in an “intervention” group who received active support to lower their blood pressure, and 16,588 people who received standard care.
The people in the intervention group were supported by specially trained non-physician healthcare providers—members of the local community who helped them stick to a treatment plan that included medication, regular monitoring, and lifestyle changes.
The target blood pressure was less than 130/80 mm Hg, which is more aggressive than what is typically recommended in many standard care settings.
After 48 months, the results were clear and meaningful. People in the intervention group lowered their systolic blood pressure (the top number) by an average of 22 mm Hg and their diastolic pressure (the bottom number) by 9.3 mm Hg compared to those in the usual care group.
More importantly, they also had a 15% lower risk of developing any form of dementia and a 16% lower risk of developing cognitive impairment without dementia (CIND), a condition often considered an early stage of mental decline.
These results are especially significant because few large trials have looked directly at whether blood pressure reduction can prevent dementia. Most previous studies have only hinted at the possibility, and very few have been designed to use dementia as a main outcome.
The well-known SPRINT-MIND trial, for example, showed only a modest and statistically non-significant 17% reduction in dementia cases through intensive blood pressure control.
“This study gives us stronger, clearer evidence,” said Professor Yingxian Sun of the First Hospital of China Medical University, one of the lead authors of the research. “For patients with high blood pressure, lowering their blood pressure is not only essential for heart health—it may also be one of the most effective ways to reduce their risk of dementia.”
The study’s large size, rural setting, and use of local community health workers also make its findings especially meaningful for low-resource areas, where access to specialized care is limited.
The successful use of non-physician health providers shows that effective interventions don’t always require expensive tools or large hospitals—they can be implemented on the ground, in local communities.
Looking ahead, researchers plan to use artificial intelligence and big data to further personalize prevention strategies and predict who may be at higher risk of dementia, even before symptoms start. These advances could help tailor blood pressure treatment and other interventions to each person’s unique risk profile.
In the meantime, the message is clear: managing high blood pressure is not just about preventing strokes and heart attacks—it could also help people stay mentally sharp and reduce the global burden of dementia.
If you care about high blood pressure, please read studies about unhealthy habits that may increase high blood pressure risk, and drinking green tea could help lower blood pressure.
For more information about high blood pressure, please see recent studies about what to eat or to avoid for high blood pressure, and 12 foods that lower blood pressure.
The research findings can be found in Nature Medicine.
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