Can Tight Blood Pressure Control Prevent Dementia?

I am Dr Richard Isaacson, director of the Alzheimer's Prevention Clinic at Weill Cornell Medicine and NewYork-Presbyterian. I'm here to talk about some very exciting results from the SPRINT MIND study, which may be the strongest evidence to date that it really is possible to delay or possibly prevent the onset of mild cognitive impairment and dementia.^[1]

The SPRINT MIND trial was a study that looked at patients who had a variety of levels of blood pressure control. The usual group tried to get a target level of systolic blood pressure at 140; however, the more aggressive or tighter-control group tried to get that systolic blood pressure down to the 120s. When you look at lowering blood pressure just by those 20 mm Hg, unbelievably, in just 3 years of treatment, with just a few years of follow-up, tight control of blood pressure reduced the incidence of mild cognitive impairment by 19%. Considering all-cause dementia, there was a reduction of 17%.

This randomized study used a variety of blood pressure medicines. The good news here is that they used generic medications and a variety of medications, and [the choice of medication] really didn't seem to matter. As long as the person was able to get tighter control of their blood pressure, they had a decreased incidence of mild cognitive impairment in a large randomized study.