MedPage Today – Reducing hypertension dropped dementia risk by 15% in the open-label China Rural Hypertension Control phase III (CRHC-3) trial of nearly 34,000 people.
At 48 months, all-cause dementia among people with high blood pressure was lower in the intervention group than in the usual care group, reported Jiang He, MD, PhD, of UT Southwestern Medical Center in Dallas, and co-authors.
A key secondary outcome — cognitive impairment without dementia — also was lower in the intervention group, He and colleagues said.
Over 4 years, blood pressure was reduced by 22.0/9.3 mm Hg in the intervention group versus usual care. Serious adverse events occurred less frequently in the intervention group (RR 0.94, 95% CI 0.91-0.98, P=0.0006).
“Our study is the first to report a statistically significant reduction in the risk of all-cause dementia associated with antihypertensive treatment, providing strong evidence to support its use for the primary prevention of dementia,” He told MedPage Today in an email.
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Mark Caulfield, MD, of Queen Mary University of London, who wasn’t part of the study, observed that “there have been prior studies suggesting correlation of blood pressure level and dementia risk — especially vascular dementia — but this is a very emphatic outcome of a trial.”
“The trial is in a Chinese population so some people might say it isn’t generalizable, but we know from other research that the correlation of blood pressure level with adverse outcomes is consistent across populations,” Caulfield posted on the U.K.’s Science Media Centre website.
“This is a really major advance in dementia prevention and will transform global blood pressure guidance and prevention strategies.”
The findings are in line with those of the SPRINT MIND trial in the U.S., which showed that tight blood pressure targets over about 3 years reduced mild cognitive impairment risk by 19% in people with hypertension.
SPRINT MIND also showed a 17% reduction in dementia risk that was not statistically significant.
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Baseline age in both groups was about 63, and approximately 61% were women. The mean 10-year risk for atherosclerotic cardiovascular disease was similar in each group …