Aggressive treatment of H B pressure/Cognitive change

[alice]

July 25, 2018


For the first time, a large, randomized clinical trial has demonstrated a significant reduction in the risk for developing cognitive decline and dementia. The new research results, announced today at the Alzheimer’s Association International Conference (AAIC), show aggressive treatment of high blood pressure (targeting a systolic blood pressure goal of less than 120 mm Hg) resulting in fewer new cases of mild cognitive impairment (slight but noticeable and measurable decline in cognitive abilities that is not severe enough to interfere with daily life) and dementia.
These findings are exciting because they show — more conclusively than ever before — that there are things we can do, especially regarding cardiovascular disease risk factors, to reduce our risk of mild cognitive impairment and dementia.
The future of dementia prevention could be in treating the whole person with a combination of drugs and modifiable lifestyle changes — as we do now in cardiovascular disease.
The Research
The SPRINT MIND trial looked at two different approaches to controlling high blood pressure and how that impacts mild cognitive impairment and dementia. In one group of participants, blood pressure was aggressively treated with a goal of a systolic pressure less than 120 mm Hg. (Systolic pressure is the pressure in your arteries when the heart pumps and is the higher number when blood pressure is measured.) In another group of participants, blood pressure was treated with a goal of a systolic pressure less than 140 mm Hg. The study participants, 9,361 hypertensive older adults, had an increased cardiovascular risk, but had not been diagnosed with diabetes, dementia or prior stroke.
The results were significant: In the group that received intensive blood pressure treatment (120 mm Hg), 19 percent less people developed mild cognitive impairment. When the researchers looked at reduction in risk of mild cognitive impairment and dementia, they found that 15 percent less people developed mild cognitive impairment or dementia (regardless of the underlying cause).
Hope on the Horizon
Research is continuing to demonstrate that dementia is not just something that happens at the end of life. Instead there are many factors throughout life that affect brain health and the risk of developing dementia, including cardiovascular health, nutrition, education and learning, and reproductive events in a women’s life, all topics with new data presented at AAIC.
While more research is needed on all causes of dementia, the new data from the SPRINT MIND trial is an exciting first in our understanding of how aggressively treating systolic blood pressure (especially for those older than the age of 50) can be part of a solution.
These new findings further reinforce the importance of the Alzheimer's Association U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER), as the study includes managing cardiovascular disease risk factors as part of the multi-component lifestyle interventions.
This two-year clinical trial funded by the Alzheimer’s Association will examine whether lifestyle interventions can protect cognitive function in older adults at increased risk for cognitive decline. The interventions include physical exercise, nutritional counseling and modification, cognitive and social stimulation, and improved self-management of health status. U.S. POINTER is the first such study to be conducted in a large group of Americans (approximately 2,000 volunteer older adults who are at increased risk for dementia will be enrolled and followed for two years). Positive results would provide evidence for behavior changes that could limit the devastating effects of dementia.
We have seen lifestyle changes have helped drive down death rates from cancer, heart disease and other major diseases and our goal is to determine if they same could be true for Alzheimer’s and other dementias. With more than 5 million Americans living with Alzheimer’s dementia today and more than 28 million baby boomers expected to develop Alzheimer’s between now and 2050, such findings could be key to lessening the symptoms and devastation of Alzheimer’s and other dementias for millions of people.