Intensive BP Control and Cognitive Function: A Randomized Clinical Trial.

Area of Science:

• Cardiology
• Neurology
• Gerontology

Background:

• Uncertainty exists regarding intensive blood pressure (BP) control effects on cognition in East Asians.
• Hypertension management strategies require evaluation for cognitive impact.

Purpose of the Study:

• To assess the effect of intensive systolic BP target (<120 mm Hg) versus standard target (<140 mm Hg) on global cognitive function.
• To evaluate cognitive safety of intensive BP lowering in Chinese hypertensive adults.

Main Methods:

• Secondary analysis of a randomized trial in 11,255 Chinese hypertensive adults with high cardiovascular risk.
• Cognitive function assessed using Mini-Mental State Examination (MMSE) at baseline and after a median of 3.4 years.
• Primary outcomes: change in MMSE score and probable dementia incidence.

Main Results:

• No significant difference in mean MMSE score change between intensive (-0.54) and standard (-0.60) BP arms.
• Results were consistent across sensitivity analyses and most subgroups.
• Probable dementia incidence was too low for interpretation.

Conclusions:

• Intensive systolic BP lowering to <120 mm Hg for 3 years did not adversely affect global cognitive function in Chinese hypertensive adults.
• The findings affirm the cognitive safety of intensive BP control strategies.
• Cognitive effects were consistent across various demographics and comorbidities.