Changes in arterial stiffness under blood pressure control are independently associated with cognitive impairment: The Systolic Blood Pressure Intervention Trial (SPRINT)

BACKGROUND: Effects of blood pressure (BP) control on the relationships between arterial stiffness and subsequent cognitive impairment remain unclear. METHODS: The Systolic Blood Pressure Intervention Trial Pulse Wave Velocity (PWV) substudy evaluated the effect BP control on total (T-PWV, in m/s), structural (S-PWV), and load-dependent (LD-PWV) arterial stiffness over 3 years as they related to time to cognitive impairment over 10 years modeled using multivariable proportional hazard models for baseline stiffness and joint longitudinal survival models for changes in stiffness. RESULTS: Six hundred fourteen participants with stiffness measures had 90 cognitive impairment events over follow-up. Reductions in LD-PWV under intensive BP control were associated with 21% risk reduction for cognitive impairment. T-PWV and S-PWV continued to increase regardless of BP control with each m/s increase in stiffness associated with 11% to 12% increase in risk for cognitive impairment. DISCUSSION: Intensive SBP control reduced LD-PWV over 3 years, which reduced the risk of cognitive impairment over 10 years of follow-up.