Lowering blood pressure could reduce the risk of dementia, study finds



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CHICAGO – Lowering blood pressure more than usual not only helps prevent heart problems, but also reduces the risk of mental decline that often leads to Alzheimer's disease, according to a major study.

A single step was clearly demonstrated to help prevent a dreaded condition that had people trying crosswords, dietary supplements and a host of other things in the hope of keeping their minds alive. alive

. a reading of 120 instead of 140 was 19% less likely to develop mild cognitive impairment. They also had fewer signs of damage to brain scans, and there was a possible trend towards fewer cases of dementia.

"This is a big breakthrough," said Dr. Jeff Williamson of the Wake Forest Baptist Medical Center in North Carolina. "It's more important than ever to work with your doctor to ensure you have good control over your blood pressure."

He led the study and gave results on Wednesday at the International Alzheimer's & Conference Association in Chicago. They are considered preliminary until publication, expected later this year.

Independent experts cheered the news.

"It's really the first time we've been able to show in a clinical trial that an aggressive management of these cardiovascular risk factors such as blood pressure can reduce the risk of cognitive impairment," Dr. Keith Fargo, director of scientific programs and operations at the Alzheimer Association, told CBS News.

His colleague, James Hendrix, Director of Global Science Initiatives at the "We have long known that high blood pressure is bad for your heart, but we are also learning that it is bad for your brain."

About 50 million people in the world suffer from dementia, and Alzheimer's disease is the most prevalent. type. There is no cure – current medications such as Aricept and Namenda simply relieve symptoms – prevention is essential.

About half of adults in the United States suffer from high blood pressure according to guidelines adopted last year. or more, rather than 140. Normal is less than 120.

High pressure can damage blood vessels and has long been badociated with a higher risk of dementia. But we do not know if lowering the pressure would reduce this risk or by how much. The federally funded study was designed to test this in the most rigorous way.

It involved more than 9,300 people at high pressure. Half of them received two medications, on average, to get their best score below 140. The rest received three medications, on average, and aimed at 120. During the study, the average pressure was 121 in the intensive treatment group and 135 in the other.

The study was stopped in 2015, almost two years earlier, when it became clear that a lower pressure was helping to prevent heart problems and deaths. But the results of these tests continued for two years and these new results were revealed Wednesday.

The researchers found a 19% decrease in mild cognitive impairment, or MCI, in the intensive-treatment group – 285 cases versus 348 the higher-pressure group. Nearly half of people with MCI develop dementia over the next five years.

"It's really more important to prevent MCI than dementia, it's like preventing hypercholesterolemia rather than heart attack," said Williamson. There was also less case of dementia in the intensive treatment group, but there was too little to say that low blood pressure was the reason. Dementia takes longer than mild impairment, doctors think the difference can widen over time.

MRIs of 454 participants showed that those in the lower pressure group had fewer white matter lesions. "That matches" the other results on thinking skills and reinforces evidence that lowering blood pressure helps, says Laurie Ryan, a dementia scientist at the National Institute on Aging.

The previous results of this study. Some doctors have criticized this as too aggressive, but the new findings, showing benefits to the brain, "support and perhaps even extend the guidelines," said Williamson. "The goal of less than 130 is extremely important."

The study did not test specific blood pressure medications. Instead, each participant's physician chose those who were available among more than a dozen.

When cardiac outcomes were announced a few years ago, doctors said that too low pressure, fainting and some kidney problems commonly occurred in the intensively treated group but that these risks were considered worth the benefits of the treatment. a lower risk of heart problems and death.

Reaching the lower level means using one more drug, and "90 percent is generic and costs less than a dollar a day," Williamson said. "For a modest cost, it has a huge benefit for people's health."

Researchers also advise you to think about your cognitive health now. If you have cardiovascular risk factors like high blood pressure, check them in your thirties and forties.

The American Heart Association recommends the following lifestyle changes to help manage high blood pressure:

  • Eating a balanced diet and low in salt
  • Limit consumption of alcohol
  • Exercise regularly
  • Manage stress
  • ] Maintain a healthy weight
  • Stop smoking
  • Take your medication as directed
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