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JAMA NetworkIdentifying Patients for Intensive Blood Pressure (BP) Treatment Based on Cognitive Benefit

Diving into intensive systolic BP treatment unveils intriguing cognitive benefits according to a secondary analysis of the SPRINT trial.

The SPRINT trial has shed fresh light on the impact of intensive systolic blood pressure (SBP) treatment on cognitive health. Out of 7,918 participants, a significant majority with higher baseline risk of dementia or mild cognitive impairment (MCI) revealed marked cognitive improvements with intensive SBP treatment. This marks a leap forward in understanding SBP treatment’s role in cognitive function preservation.

In the comprehensive secondary analysis, patients were meticulously followed up over a median of four years. To streamline the study, two SBP treatment targets were identified: intensive, set at less than 120 mm Hg, and standard, at less than 140 mm Hg. The data collected showcased 765 and 828 primary outcome events in intensive and standard treatment groups, respectively. Consequently, it confirmed intensive SBP treatment’s potential in reducing the risk of MCI or dementia.

Digging deeper into the data, certain trends emerged. Older age, Medicare enrollment, and higher baseline serum creatinine levels correlated with a higher risk of the primary outcome. Conversely, enhanced baseline cognitive functioning and active employment status signified lower risk. Interestingly, higher baseline risk connected directly with greater benefits from intensive treatment, underscored by a larger reduction in probable dementia or MCI. This implies that intensive SBP treatment may offer significant cognitive benefits, especially for high-risk individuals.

Overall, the study suggests that intensive SBP treatment could be a strategic approach for patients with an elevated baseline risk of MCI or dementia. Future research will undoubtedly build on these findings, perhaps reshaping guidelines for blood pressure management in cognitive health contexts.

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