Hypotension associated with a lower risk of dementia

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LOS ANGELES – For hypertensive patients who hope to escape dementia, doctors also advise those seeking to protect their heart and kidneys: "Descend"

. The fact that patients' systolic blood pressure readings dropped to a new lower target level reduced their risk of developing mild cognitive impairment, or MCI, by almost 20%. MCI is a decline in memory and thinking skills that is low but noticeable, and affects between 15 and 20% of people over 65 years old. For more than half of those diagnosed with MCI, a diagnosis of dementia will occur later. The new study found that compared to subjects whose blood pressure control regimen was more relaxed, subjects whose blood pressure was more strictly controlled were 15% less likely to be diagnosed with mild cognitive impairment and the subsequent dementia. On Wednesday at the International Conference of the Alzheimer's Association in Chicago, a year after the American Heart Association and the American College of Cardiology have adopted a new target for people with hypertension. Groups of physicians had long considered that blood pressure readings of 140/90 mmHG were an acceptable target for people with hypertension, but in 2017, they urged doctors to bring their patients suffering from hypertension. arterial hypertension at 130/80 mmHG

. new research suggests that there are powerful benefits to getting the first number in this reading – systolic blood pressure – to an even lower target: 120 mmHG

Systolic blood pressure is the amount of pressure in the arteries of a person during the contraction of the heart muscle. Because it is the highest pressure at which blood vessels are subjected, systolic blood pressure is considered to have the most detrimental impact on the delicate capillaries that nourish the brain as well as the kidneys, the heart and liver. In large populations, lowering this reading to 120 already has been found to reduce rates of cardiovascular disease and kidney failure.

The new findings emerge from a clinical trial called SPRINT (abbreviation for Systolic Blood Pressure Intervention Trial), which began in 2010 and ran for less than five years. After the subjects of the trial were followed for a little over three years on average, the trial was closed because the trial results showed so strongly the benefits of the lower systolic blood pressure goal. in the protection of hearts. In August 2015, a safety oversight committee stated that it could no longer justify the maintenance of certain subjects at the systolic target level of 140 mmHG

"What SPRINT has shown , that's what's good about your brain, "said lead author of the SPRINT Mind study, Dr. Jeff Williamson of the Wake Forest School of Medicine, who presented the results Wednesday in Chicago

Williamson called it "very encouraging." Pressure control would also show powerful protective effects for the brain.If the trial lasted longer, he said, there are Reasons to believe that more cases of mild cognitive impairment and dementia could be prevented.

The 8226 subjects in the SPRINT Mind trial ranged in age from 50 to 100 years and were considered to have an increased risk of cardiovascular disease. After a year in the test, the people They were badigned to treat their blood pressure at the stricter target and had an average systolic blood pressure of 121.4 mmHG. Those badigned to the "standard treatment group" had an average systolic blood pressure of 136.2 mmHG

. Lon Schneider, Alzheimer's disease specialist at the Keck School of Medicine at USC, praised these results. But he suggested that the average age of the test subjects might obscure an important point: strict control of blood pressure will likely prevent dementia most effectively if it starts early and is followed for a long time. the quarantine

. to blood vessels cumulatively over several years. Research suggests that decades before memory and thinking declines are remarkable, hypertension can begin to damage the complex network of small blood vessels in the brain and pave the way for further damage, said Schneider. ages, he said. But mid-life, tighter control can prevent the appearance of blood vessel lesions. If it does not start before the person is old enough, it may be too late to stop this slide into organ damage and, in the case of the brain, dementia, he said.

Tribune News Service