Intensive blood-pressure reduction (systolic BP < 120 mm Hg) reduces the risk of cognitive impairment in older adults compared to standard targets (<140 mm Hg), informing future trial designs.
A large interventional trial, the Systolic Blood Pressure Intervention Trial sub-study termed Memory and Cognition in Decreased Hypertension (SPRINT-MIND), found reduced risk of cognitive impairment in older adults with intensive, relative to standard, blood-pressure-lowering targets (systolic BP 80 years), will maximize external validity and global implementation of trial findings. New biomarkers will improve phenotyping to stratify patients to optimal treatments. Currently no antihypertensive drug class stands out for dementia risk reduction. Multi-domain interventions, incorporating lifestyle change (exercise, diet) alongside medications, may maximize global impact. Given the low cost and wide availability of antihypertensive drugs, intensive BP reduction may be a cost-effective means to reduce dementia risk in diverse, aging populations worldwide.
Elahi et al. (Thu,) conducted a review in Vascular cognitive impairment. Intensive blood-pressure-lowering vs. Standard blood-pressure-lowering (systolic BP < 140 mm Hg) was evaluated. Intensive blood-pressure reduction (systolic BP < 120 mm Hg) reduces the risk of cognitive impairment in older adults compared to standard targets (<140 mm Hg), informing future trial designs.
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