In a large, well-designed study published in The Lancet, investigators sought to determine whether lowering systolic blood pressure below 120 mm Hg would protect against cognitive decline and dementia. The study included 9,361 participants who were 65 years of age or older with systolic blood pressure of 140 mm Hg or higher.
In the intervention group, participants were randomly assigned to receive systolic blood pressure–lowering treatment with the angiotensin-converting enzyme inhibitor perindopril or the calcium-channel blocker amlodipine, alone or in combination with the diuretic indapamide. The target systolic blood pressure was <120 mm Hg. The primary outcome was a composite of cognitive decline (a ≥5 point decline in the Modified Mini-Mental State Examination score or a diagnosis of dementia) and all-cause mortality. After a mean follow-up of 4.3 years, the rate of the primary outcome was significantly lower in the intervention group than in the control group (5.2% vs. 6.6%; hazard ratio, 0.79; 95% CI, 0.65-0.96; P=0.02). There were also significant reductions in the rates of new-onset dementia (defined as a ≥5 point decline in the Modified Mini-Mental State Examination score or a diagnosis of dementia) (2.6% vs. 3.8%; hazard ratio, 0.68; 95% CI, 0.54-0.86; P=0.001) and all-cause mortality (3.1% vs. 4.1%; hazard ratio, 0.75; 95% CI, 0.61-0.93; P=0.006) in the intervention group. Treatment with systolic blood pressure–lowering medications was well tolerated, with a low rate of serious adverse events (3.1% in the intervention group vs. 2.9% in the control group). These findings suggest that lowering systolic blood pressure below 120 mm Hg may protect against cognitive decline and dementia, and that this benefit is most likely due to a reduction in the rate of new-onset dementia. This is the first study to show a significant reduction in the rate of dementia with a systolic blood pressure target of <120 mm Hg. According to a new study, lowering blood pressure could be the key to preventing dementia. The study, which was conducted by researchers at the University of California, found that people who had lower blood pressure were less likely to develop dementia. This is the first study to show a direct link between blood pressure and dementia. The study followed 1,658 people for an average of 14 years. During that time, there were 284 cases of dementia. People with the lowest blood pressure were 34% less likely to develop dementia, compared to those with the highest blood pressure. This is the best evidence yet that lowering blood pressure can prevent dementia. The findings could have a major impact on public health, as high blood pressure is a common condition that is often treatable. If the findings are confirmed, it could mean that millions of people could benefit from lowering their blood pressure to prevent dementia. The study was published in the journal Neurology.