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TAMPA, FLORIDA – Aggressive treatment to lower blood pressure in seniors reduces the risk of developing mild cognitive impairment, a risk factor for dementia, US researchers said Monday.
The findings of the Journal of the American Medical Association (JAMA) revealed no significant impact on the likelihood of developing dementia, but experts said the trial offered a glimmer of hope as the world's population ages and that dementia was becoming a growing concern.
Dementia, including its most common form, Alzheimer's disease, is expected to affect 115 million people worldwide by 2050.
To date, the world's best scientists have not found a way to reliably prevent, cure or treat dementia.
Some research suggests, however, that high blood pressure – which affects three-quarters of people over 75 – may be an modifiable risk factor.
For the Systolic Blood Pressure Intervention Test (SPRINT), more than 9,300 people aged 50 years and over with high blood pressure (systolic blood pressure between 130 and 180 mmHg) were randomized to receive various interventions. .
Some have received intensive blood pressure control, with drugs targeting 120 mmHg.
Others aimed for a more standard treatment goal of less than 140 mmHg.
The patients were followed for about five years and subjected to a battery of cognitive tests.
In the intensive treatment group, 149 participants were considered to have probable dementia, compared with 176 participants in the standard treatment group.
In other words, the intensive control of blood pressure "did not significantly reduce the incidence of likely dementia," the study said.
However, the researchers were cautiously optimistic about the secondary finding, that a mild cognitive impairment occurred in a much smaller number of participants in the intensive-treatment group or 287 compared to 353 participants in the standard treatment group.
"This is the first trial, to our knowledge, to demonstrate an intervention that significantly reduces the occurrence of ICM, a well-established risk factor for dementia," the study said.
A JAMA companion editorial written by Kristine Yaffe of the University of California at San Francisco also highlighted the possibility that additional research could confirm the technique as an effective prevention strategy.
"SPRINT MIND offers great hope to seniors, almost all of whom are worried about Alzheimer's disease and related dementias, so they have great hope," she wrote.
"The study demonstrates that in people with hypertension, intensive control of PAS can reduce the development of cognitive impairment."
She called for studying this approach as well as other efforts in vascular health, such as physical activity and prevention.
Maria Carrillo, scientific leader of the Alzheimer's Association, which is funding a two-year extension of the study to further study the effects on dementia, called these findings "the strongest evidence to date." day about reducing the risk of mild cognitive impairment by treating high blood pressure.
"MCI is a known risk factor for dementia, and all people with dementia go through the MCI," Carrillo added.
"However, the results of the study on reducing the risk of dementia were not final", hence the need for further research, she said.
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