Intensive blood pressure treatment reduces memory and thinking decline

Posted on 28th January 2019

JAMA: Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia: A Randomized Clinical Trial

Researchers from the SPRINT MIND study in the US have found that treating high blood pressure reduces the risk of mild cognitive impairment (MCI). The results are published today (Monday 28 January) in the scientific publication JAMA.

The new findings come for the Systolic Blood Pressure Intervention Trial (SPRINT), which was designed to test the effect of intensive blood pressure control on cardiovascular health and memory and thinking skills

Systolic blood pressure measures the pressure in blood vessels when the heart beats, whereas diastolic blood pressure measures the pressure in blood vessels when the heart rests. Guidelines from the National Institute for Health and Care Excellence give a threshold of 140 mmHg systolic blood pressure for doctors to diagnose high blood pressure, but the NHS suggests that blood pressure should be below 120 mmHg to fall within the ideal range.

Participants in this study were people over the age of 50 with high blood pressure and without diabetes or history of stroke. Researchers split the participants into two separate groups.

Doctors treated people in the first group with the goal of reducing their blood pressure to below 140mmHg, while they treated the second group with a goal of blood pressure below 120mmHg.

The researchers looked at data from 8,563 people who had at least one follow-up memory and thinking assessment after their treatment.

The study did not show additional benefits on dementia risk for lowering blood pressure below 120mmHg compared to 140mmHg. However, it did show that more intensive blood pressure control was associated with a lower risk of mild cognitive impairment – less severe memory and thinking changes that can precede dementia.

The study was finished early due to the cardiovascular benefits seen in the study’s volunteers.

Dr Rosa Sancho, Head of Research from Alzheimer’s Research UK, said:

“We know having high blood pressure is a risk factor for dementia as well as other health conditions and that controlling it can have wide ranging benefits. This study suggests that treating high blood pressure intensively to maintain it in the ideal, healthy range, may help to reduce the risk of mild memory and thinking problems.

“It’s good to see that parts of this trial will now be extended to give a clearer idea of whether more ambitious targets for blood pressure treatment could have an impact on dementia risk. With no treatments able to slow or stop the diseases that cause dementia it is important to find new ways to reduce dementia risk or delay the onset of the condition.

“The NHS currently advises that blood pressure should not be above 120/80mmHg and that people over 40 should have their blood pressure checked regularly. Anyone with any concerns about their blood pressure should speak to their GP.

“There is strong evidence to suggest that what’s good for the heart is also good for the brain and maintaining good vascular health is one of the key things people can do to reduce their risk of dementia. As well as maintaining a healthy blood pressure, the best current evidence suggests that not smoking, drinking in moderation, staying mentally and physically active, eating a balanced diet, and keeping cholesterol levels in check can all help to keep our brains healthy as we age.”

Posted in Science news