Less Dementia Risk with Intensive Blood Pressure Treatments

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In a 2018 study, treating blood pressure more aggressively lowered odds of developing mild cognitive impairment, a gateway to dementia. CBS News chief medical correspondent Dr. Jon LaPook explains.

CHICAGO — The first randomized clinical trial to demonstrate that intensive blood pressure treatment reduces new cases of mild cognitive impairment (MCI), and the combined risk of MCI plus all-cause dementia, was the highlight of new research results that were presented at the 2018 Alzheimer’s Association International Conference (AAIC) held in Chicago. (Ed. Note: We continue to present important research from these conferences.)

MCI is often nicknamed “PRE-DEMENTIA”. If the risk for MCI is lowered, it implies that the risk for dementia is lowered.

Reducing Risk

The preliminary results of the SPRINT MIND trial, presented at AAIC 2018, provided the strongest evidence to date about reducing risk of MCI and dementia through the treatment of high blood pressure, which is one of the leading causes of cardiovascular disease worldwide.

“The exciting data from innovative research studies reported at AAIC 2018 give us many reasons to be hopeful,” said Maria C. Carrillo, PhD, Alzheimer’s Association Chief Science Officer. “For example, the reduction in new cases of MCI seen in the SPRINT MIND study adds credibility to the vision of future Alzheimer’s therapy that combines drugs and modifiable risk factor interventions — as we do now in cardiovascular disease.”

Better Dementia Prevention Strategies

“We welcome innovative clinical trial designs and therapeutic targets, and new methods of delivering therapies and attacking the disease, as we heard presented at AAIC,” Carrillo said. “A new therapy has not been approved in a long time. We need bold steps — from basic science all the way through clinical trials — to provide better treatments and prevention strategies for the millions of people living with Alzheimer’s and other dementias, and the millions more at risk.”

New SPRINT MIND Trial

Researchers reported preliminary results related to risk of dementia and cognitive decline from the Systolic Blood Pressure Intervention Trial (SPRINT). SPRINT is a randomized clinical trial that compares two strategies for managing high blood pressure (hypertension) in older adults: an intensive strategy with a systolic blood pressure goal of less than 120 mm Hg versus a standard care strategy targeting a systolic blood pressure goal of less than 140 mm Hg.

SPRINT Memory and Cognition IN Decreased Hypertension (SPRINT MIND) examined whether treating for the lower blood pressure target reduces the risk of developing dementia and/or MCI. Study participants were 9,361 hypertensive older adults with increased cardiovascular risk but without diagnosed diabetes, dementia or stroke. Participant mean age was 67.9 years (35.6 percent women) and 8,626 completed at least one follow-up cognitive assessment.

Significantly Lower Rate

In SPRINT MIND, the researchers found a statistically significant 19 percent lower rate of new cases of MCI in the intensive blood pressure treatment group. The combined outcome of MCI plus probable all-cause dementia was 15 percent lower in the intensive versus standard treatment group.

“This study shows more conclusively than ever before that there are things you can do — especially regarding cardiovascular disease risk factors — to reduce your risk of MCI and dementia,” said Carrillo.