Dementia risk and blood pressure levels

Lowering blood pressure (BP) with antihypertensive agents is linked to a significant reduction in the risk of dementia or cognitive impairment, new research suggests.

Results from the latest, and largest, meta-analysis to date shows BP-lowering was associated with a 7% reduction in incident cognitive impairment or dementia.

The reduction was significant compared with placebo or other control and is important from a global perspective.

The new meta-analysis is the first to include both Systolic Blood Pressure Intervention Trial Memory and Cognition in Decreased Hypertension (SPRINT MIND) and Heart Outcomes Prevention Evaluation-3 (HOPE-3) trials.

The investigators found BP lowering with antihypertensive agents was significantly associated with a reduction in dementia or cognitive impairment compared with a control, regardless of the control type (7.0% vs 7.5%; odds ratio [OR], 0.93 [95% confidence interval [CI] 0.88 - 0.98]; absolute risk reduction [ARR] 0.39% [95% CI, 0.09% - 0.68%]).

A secondary outcome was cognitive decline, defined as a cognitive score that decreased by an absolute value. In eight trials reporting this outcome, BP lowering with an antihypertensive agent was significantly associated with a reduction in cognitive decline compared with a control (20.2% vs 21.1%; OR, 0.93 [95% CI, 0.88 - 0.99]; ARR, 0.71% [95% CI, 0.19% - 1.2%].)