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Intensive BP Control and Cognitive Function: A Randomized Clinical Trial

Bin Wang1,2, Ying Sun1, Yan Li1

  • 1National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China (B.W., Y.S., Y. Li, Y.P., S.L., J.G., L. Zhang, L. Zhao, Jiangling Liu, H.Z., Jiamin Liu, Jing Li).

Hypertension (Dallas, Tex. : 1979)
|February 26, 2026
PubMed

Insights

Intensive blood pressure control in Chinese adults did not negatively impact cognitive function. This study confirms the cognitive safety of targeting lower systolic blood pressure (<120 mm Hg) in hypertensive individuals.

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.
Abstract

Keywords:
blood pressurecognitionevidence gapincidencepublic health

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