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August 14, 2019

Intensive blood pressure control may slow dementia progression

Intensive blood pressure control may be crucial for preventing the development of the white matter lesions characteristic of dementia, according to a new study.

By Chloe Kent

Intensive blood pressure control may be crucial for preventing the development of the white matter lesions characteristic of dementia, according to a new study.

The study, funded by the US National Institutes of Health (NIH), found that intensively controlling a person’s blood pressure was 57% more effective at slowing the accumulation of white matter lesions than standard treatment of high blood pressure.

White matter lesions represent an increase in water content in the brain, and reflect a variety of changes within the brain. This includes the thinning of myelin, a fatty coating which projects axons from injury and speeds the flow of electrical signals, increased glial reactions to injury, leaky brain blood vessels or multiple strokes. These changes are all associated with high blood pressure.

Through the NIH Systolic Blood Pressure Intervention Trial (SPRINT), researchers worked with over 9,300 adults of at least 50 years of age who had high risk of cardiovascular disease. The patients received either standard blood pressure control treatment, which lowered systolic blood pressure to less than 140 mm Hg, or intensive treatment which lowered the same pressure reading below 120 mm Hg.

Brain scans of 449 participants were taken at enrolment, then taken again four years later.

The average increase in total volume of white matter lesions in the scans of the intensive treatment group was 0.92 cm3, compared to 1.45cm3 in the standard treatment group.

NIH National Institute of Neurological Disorders and Stroke director Walter Koroshetz said: “These initial results support a growing body of evidence suggesting that controlling blood pressure may not only reduce the risk of stroke and heart disease but also of age-related cognitive loss.”

Several studies have linked hypertension to greater chances of accumulating white matter lesions and experiencing cognitive disorders and dementia in later life.

Koroshetz said: “I strongly urge people to know your blood pressure and discuss with your doctors how to optimize control. It may be a key to your future brain health.”

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