25 Jan Blood Pressure Control – Good for Heart, Good for the Brain!
MedicalResearch.com Interview with:
Jeff D. Williamson, MD
Geriatric Medicine – Sticht Center
Wake Forest Baptist Medical Center
MedicalResearch.com: What is the background for this study?
Response: A growing amount of epidemiologic research has suggested that higher blood pressure is associated with higher risk for dementia, including Alzheimer’s dementia.
MedicalResearch.com: What are the main findings?
Response: More than 9,300 ambulatory, community dwelling persons over age 50, 30% of whom were over the age of 75, were randomly assigned to a blood pressure goal of 120 vs 140. Persons in the 120 group had a 19% lower risk for developing MCI an transitional stage between normal and dementia (P<.008). There was a 17% lower risk for developing dementia but this only achieved a p value = 0.10. The combined risk for both MCI and dementia was 15% lower in the 120 group (p<0.04). The dementia outcome was the primary outcome but all the outcomes were pre-specified in the protocol at the beginning of the trial. Unfortunately the blood pressure intervention was stopped after only 3.3 years due to CVD and mortality benefit and this may well have influenced the ability to reach the expected number of dementia cases.
MedicalResearch.com: What should readers take away from your report?
Response: That this is the first large RCT in history to show conclusively that an intervention, in this case intensive systemic blood pressure control, can reduce the risk for MCI or the combination of MCI and Dementia.
There is also no evidence that intensive blood pressure control to a goal of 12 harms the brain.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: First, additional follow-up of this cohort may help ally the lingering uncertainty about the effect on dementia risk.
Second, this study opens a wide avenue to further research on vascular interventions and vascular mechanisms for reducing the risk for dementia.
MedicalResearch.com: Is there anything else you would like to add?
Response: What is good for your heart, in terms of blood pressure control, has now been proven to be good for your brain!
The SPRINT MIND Investigators for the SPRINT Research Group. Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia: A Randomized Clinical Trial. JAMA. Published online January 28, 2019. doi:10.1001/jama.2018.21442
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