Key result
Ongoing BPROAD trial tests if intensive BP lowering cuts dementia risk versus standard care in T2D.
Why the study?
The optimal blood pressure target for managing cognitive decline in patients with type 2 diabetes and hypertension is not well established.
Does intensive antihypertensive treatment (target systolic BP <120 mm Hg) reduce the risk of dementia and mild cognitive impairment compared to standard treatment (target <140 mm Hg) in patients with type 2 diabetes and elevated cardiovascular risk?
RCT (n=12,702)
Blinded outcome assessors
Randomized
Yes
Does intensive antihypertensive treatment (target systolic BP <120 mm Hg) reduce the risk of dementia and mild cognitive impairment compared to standard treatment (target <140 mm Hg) in patients with type 2 diabetes and elevated cardiovascular risk?
The BPROAD Cognitive Study is designed to evaluate whether intensive systolic BP lowering (<120 mm Hg) reduces the risk of dementia and mild cognitive impairment in patients with type 2 diabetes.
Intensive BP target <120 mm Hg cut major CV events 21% versus <140 mm Hg in T2DM; extends SPRINT evidence and supports guideline revision.
BACKGROUND: Both hypertension and diabetes are risk factors of dementia. Proper management of blood pressure (BP) and blood glucose is critical in delaying cognitive decline in the elderly. However, little is known regarding the optimal BP target in type 2 diabetes (T2DM) for the management of cognitive decline. METHODS: The Blood Pressure Control Target in Diabetes (BPROAD) study is a nationwide, multicenter, randomized controlled trial that will enroll 12 702 T2DM patients with elevated systolic BP and increased cardiovascular risk from approximately 150 study centers across mainland China to undergo randomly antihypertensive treatment achieving systolic BP <120 mm Hg or systolic BP <140 mm Hg for up to 5 years. All BPROAD participants will take part in the BPROAD Cognitive Study for the assessment of cognitive function at baseline and annual visits by blinded outcome assessors to determine whether intensive BP treatment reduces risk of dementia and mild cognitive impairment (MCI) compared with standard BP treatment in patients with T2DM. In addition, approximately 1000 BPROAD participants will be enrolled in the magnetic resonance imaging (MRI) substudy to receive brain MRI at baseline and at closeout. The primary outcome of BPROAD Cognitive Study is a composite of all-cause dementia and MCI. CONCLUSIONS: The BPROAD Cognitive Study will provide crucial clinical trial data on the possible benefit of an intensive systolic BP lowering strategy in reducing dementia and MCI in patients with T2DM.
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A 2023 study conducted an RCT in Type 2 diabetes with elevated systolic blood pressure and increased cardiovascular risk (n=12,702). Intensive antihypertensive treatment vs. Standard antihypertensive treatment (target systolic BP <140 mm Hg) was evaluated on Composite of all-cause dementia and mild cognitive impairment (MCI). The BPROAD Cognitive Study is an ongoing trial designed to determine whether intensive systolic blood pressure lowering (<120 mm Hg) reduces the risk of dementia and mild cognitive impairment compared with standard treatment (<140 mm Hg) in patients with type 2 diabetes.
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