Systematic review: blood pressure lowering in patients without prior cerebrovascular disease for prevention of cognitive impairment and dementia

Hypertension and cognitive impairment are prevalent in older people. Hypertension is a direct risk factor for vascular dementia, and recent studies suggest hypertension also impacts on the prevalence of Alzheimer’s disease. The question is therefore whether treatment of hypertension lowers the rate of cognitive decline. To assess the effects of blood pressure (BP) lowering treatments for the prevention of dementia and cognitive decline in patients with hypertension but no history of cerebrovascular disease. Trials were identified through a search of the Cochrane Dementia and Cognitive Impairment Group’s Specialised Register which contains records from CENTRAL, MEDLINE, EMBASE, PsycINFO and CINAHL. Relevant journals were searched, drug companies, colleagues and researchers were contacted, and reference lists of all trials identified were screened. Randomised, double blind, placebo controlled trials in which pharmacological or non-pharmacological interventions to lower BP were given for at least 6 months. Two independent reviewers assessed trial …