Maintaining strict blood pressure control, even for a short period, could provide lasting benefits for brain health in older adults, according to a recent clinical trial.
Individuals with blood pressure maintained at around 120 systolic for three and a half years had a lower risk of mild cognitive impairment or dementia, as highlighted in findings recently published in the journal Neurology. The systolic pressure, the upper number in a blood pressure reading, measures the pressure in arteries as the heart pumps blood.
This reduced risk persisted in older adults long after they stopped receiving intensive blood pressure treatment.
Findings from the Study
“Our study demonstrates that intensive blood pressure control is an essential strategy for preventing cognitive decline, a major cause of loss of independence in older adults,” said Dr. Jeff Williamson, senior researcher and professor of gerontology and geriatric medicine at Wake Forest University School of Medicine in Winston-Salem, North Carolina.
“Lowering blood pressure to more aggressive targets can improve quality of life and extend active years for people with hypertension,” Williamson added in a press release.
This study builds on findings from a landmark clinical trial in 2015, which reported that intensive blood pressure control reduced the risk of heart disease and death by 30% to 40% in individuals with high blood pressure.
The trial, known as the Systolic Blood Pressure Intervention Trial (SPRINT), compared the health outcomes of individuals with a target systolic pressure of 120 versus 140.
Cognitive Benefits Observed
In 2019, additional results from SPRINT indicated a significantly reduced risk of mild cognitive impairment during up to five years of intensive blood pressure control.
The latest findings from SPRINT followed patients for a longer duration—at least seven years—and confirmed that the cognitive benefits of controlling blood pressure are indeed enduring.
This report involved over 7,000 participants from the initial trial who could be re-contacted. These individuals underwent cognitive tests to evaluate their brain function.
Participants who received intensive blood pressure treatment during the trial were 13% less likely to develop mild cognitive impairment and 11% less likely to experience mild cognitive impairment or dementia, compared to those with a higher blood pressure target.
Longevity of the Benefits
“Over a median of nearly seven years of follow-up, we observed that the previously reported statistically significant reduction in cognitive impairment rates remained consistent,” the researchers noted.
“It’s important to remember that participants randomly assigned to intensive treatment underwent an average of only 3.3 years of intervention, after which the same level of intensive hypertension management was generally not maintained,” they added.
“These findings support intensive blood pressure treatment as a vital strategy for preventing cognitive decline and suggest some degree of persistent benefit in preventing cognitive impairment even after a few years of intensive treatment,” the researchers concluded.
Current Guidelines for Blood Pressure
According to current blood pressure guidelines, normal blood pressure is defined as 120 or less, elevated blood pressure as 120 to 129, and high blood pressure as 130 or higher. These guidelines, established by leading heart health groups in 2017, were partly based on the initial results of the SPRINT trial.
By controlling blood pressure more aggressively, even for a short time, it’s possible to achieve lasting cognitive benefits and help reduce the risk of dementia. This emphasizes the importance of regular monitoring and proactive management of hypertension for overall brain health.