Intensive BP Control Helps Prevent Mild Cognitive Impairment

By Amy Orciari Herman

Intensive blood pressure (BP) control in older adults does not lower the risk for dementia, but it does appear to prevent mild cognitive impairment — a precursor to dementia — according to an analysis from the SPRINT trial published in JAMA.

Over 9000 adults aged 50 and older with systolic BP between 130 and 180 mm Hg and high cardiovascular risk, but without diabetes, dementia, or prior stroke, were randomized to intensive BP lowering (systolic goal, <120 mm Hg) or standard treatment (<140 mm Hg). Treatment lasted a median of 3 years, and patients were followed for cognitive outcomes over a total of 5 years.

The primary outcome, probable dementia, did not differ significantly between intensive and standard BP lowering (7.2 cases per 1000 person-years with intensive BP lowering vs. 8.6 per 1000 with standard treatment). However, mild cognitive impairment was reduced significantly with intensive treatment (14.6 vs. 18.3 per 1000 person-years).

An editorialist points out study limitations but concludes that this “represents a major leap forward in what has emerged as a marathon journey” toward preventing cognitive impairment.