Breakthrough Study Confirms Blood Pressure Control Reduces Dementia Risk
A groundbreaking study from Wake Forest University School of Medicine reveals that just 3½ years of intensive blood pressure control can provide lasting protection against cognitive decline.
Even years after stopping treatment, participants who aggressively managed their blood pressure showed a significantly lower risk of developing mild cognitive impairment or dementia.
Sustained Cognitive Benefits from Intensive Blood Pressure Control
A study from Wake Forest University School of Medicine reveals that just 3½ years of intensive blood pressure management can significantly lower the risk of mild cognitive impairment and dementia, even years after stopping treatment. The findings emphasize the long-term brain benefits of aggressive blood pressure control in adults with hypertension and high cardiovascular risk.
Published in Neurology, the medical journal of the American Academy of Neurology, the study highlights how sustained blood pressure management helps prevent cognitive decline.
Examining the SPRINT MIND Study and Its Participants
The research was part of the Systolic Blood Pressure Intervention Trial (SPRINT) Memory and Cognition in Decreased Hypertension (SPRINT MIND), a large, NIH-supported study involving 9,361 adults aged 50 and older across more than 100 U.S. and Puerto Rican clinical sites. Participants were randomly assigned to one of two treatment goals: a systolic blood pressure target of less than 120 mm Hg (intensive treatment) or less than 140 mm Hg (standard treatment).
Participants were monitored for a median of seven years, with cognitive assessments conducted in-person and by phone. Based on these evaluations, they were classified as having no cognitive impairment, mild cognitive impairment, or probable dementia.
Lower Risk of Cognitive Impairment with Aggressive Treatment
“We found that the intensive treatment group had a sustained lower incidence of developing cognitive impairment compared to those in the standard treatment group,” said David M. Reboussin, Ph.D., professor of biostatistics and data science at Wake Forest University School of Medicine and the study’s corresponding author.
The findings showed that intensive treatment reduced both the likelihood of mild cognitive impairment and the combined risk of mild cognitive impairment or probable dementia.
Building on Earlier Findings of the SPRINT Trial
In 2015, published findings from the landmark SPRINT trial showed that intensive blood pressure management reduced cardiovascular disease and lowered the risk of death by 30-40% in persons with hypertension. SPRINT was stopped early due to the success of the trial in reducing cardiovascular disease. As a result, participants were on intensive blood pressure lowering treatment for a shorter period than originally planned. The authors at that time concluded that the shorter time made it difficult to accurately determine the role of intensive blood pressure control in dementia cases.
Extending the Cognitive Protection Beyond Five Years
Five years later, in 2019, initial results of SPRINT MIND, led by Wake Forest University School of Medicine, showed that there was a significantly reduced risk of developing mild cognitive impairment for up to five years following the initial 3.3 years of intensive blood pressure control.
These latest SPRINT MIND findings showed the same previously observed significant reduction in cognitive impairment rates, but over a longer period—at least seven years.
A Path Forward for Brain Health and Hypertension Management
“Our study shows that intensive blood pressure control is an important strategy in the prevention of cognitive impairment, a major cause of loss of independence in older adults,” said Jeff Williamson, M.D., M.H.S, professor of gerontology and geriatric medicine at Wake Forest University School of Medicine. “Lowering your blood pressure to more aggressive targets can improve the quality of life and extend active life for individuals with hypertension.”
Reference: “Long-Term Effect of Intensive vs Standard Blood Pressure Control on Mild Cognitive Impairment and Probable Dementia in SPRINT” by David M. Reboussin, Sarah A. Gaussoin, Nicholas M. Pajewski, Byron C. Jaeger, Bonnie Sachs, Stephen R. Rapp, Mark A. Supiano, Maryjo L. Cleveland, Valerie Hunter, Jamehl L. Demons, Paula K. Ogrocki, Alan Jay Lerner, Gordon J. Chelune, Virginia G. Wadley, Margaret L. Scales, Nancy F. Woolard, Letitia H. Perdue, Kathryn E. Callahan and Jeff D. Williamson, 16 January 2025, Neurology.
The study was supported by NIH grant R01AG055606 and the Alzheimer’s Association. SPRINT was supported by the NIH including the National Heart, Lung and Blood Institute, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute on Aging, and the National Insitute of Neurological Disorders and Stroke under grants HHSN268200900040C, HHSN268200900046C, HHSN268200900047C, HHSN268200900048C, HHSN268200900049C and A HL-13-002-001.