Intensive BP Reduction Effective for Lowering All-Cause Dementia Risk

TUESDAY, April 29, 2025 (HealthDay News) — An intensive blood pressure (BP) reduction intervention is effective for lowering the risk for all-cause dementia among individuals aged 40 years and older with untreated hypertension, according to a study published online April 21 in Nature Medicine.

Jiang He, M.D., Ph.D., from UT Southwestern Medical Center in Dallas, and colleagues randomly assigned 163 villages in rural China to a nonphysician community health care provider-led intervention and 163 villages to usual care to examine the effectiveness of BP reduction on dementia among 33,995 individuals aged 40 years and older with untreated hypertension. Trained nonphysician community health care providers in the intervention group initiated and titrated antihypertensive medications according to a simple stepped-care protocol to achieve a systolic/diastolic BP goal of <130/<80 mm Hg, with primary care physician supervision.

The researchers found that the net reductions in systolic and diastolic BP were 22.0 and 9.3 mm Hg, respectively, over 48 months in the intervention group compared with usual care. The intervention group had a significantly lower primary outcome of all-cause dementia than the usual care group (risk ratio, 0.85). The intervention group also had less frequent serious adverse events (risk ratio, 0.94).

“The effectiveness of BP reduction on the risk of dementia was consistent across subgroups based on age, sex, education, history of cigarette smoking, body mass index, systolic BP, fasting plasma glucose and 10-year atherosclerotic cardiovascular disease risk at baseline,” the authors write.

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