Intensive BP control does not reduce dementia incidence

  • JAMA

  • curated by Emily Willingham, PhD
  • Clinical Essentials
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Intensive BP control did not reduce dementia incidence but mitigated incident mild cognitive impairment (MCI) in this analysis from the Systolic Blood Pressure Intervention Trial ( SPRINT ).
  • The authors say a longer follow-up in this SPRINT Memory and Cognition in Decreased Hypertension (MIND) study might uncover a link to dementia as well.

Why this matters

  • Hypertension might be a modifiable factor linked to dementia risk, although some studies have linked low BP with increased risk for cognitive impairment.
  • Editorial: a limitation is that SPRINT excluded people with common conditions of aging, including diabetes, stroke, and heart failure.

Key results

  • Probable dementia diagnoses:
    • Intensive treatment: 7.2/1000 person-years vs
    • Standard treatment: 8.6/1000 person-years;
    • HR, 0.83 (95% CI, 0.67-1.04; not significant).
  • MCI:
    • Intensive treatment: 14.6/1000 person-years vs
    • Standard treatment: 18.3/1000 person-years;
    • HR, 0.81 (95% CI, 0.69-0.95).
  • Controlling for extended follow-up suggested that with longer follow-up, more cases of dementia/MCI would be identified, with results favoring intensive treatment.

Study design

  • Data for 9361 SPRINT participants analyzed (mean age, 67.9 [standard deviation, 9.4] years).
  • Intensive treatment (systolic BP
  • Outcomes: probable dementia, MCI, composite of both.
  • Funding: NIH; others.

Limitations

  • MCI prevalence at baseline not known.