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Cardiometabolic Renal Health Profile, Intensive Blood Pressure-Lowering Treatment and Cognitive Dysfunction: A Post

Siyu Wang1,2, Kan Wang1,2, Zhiping Tan1,2

  • 1Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Diabetes, Obesity & Metabolism
|August 13, 2026
PubMed

Insights

Intensive blood pressure lowering treatment may benefit cognitive health, particularly for those with favorable cardiometabolic and renal profiles. Further research is needed to confirm these findings on mild cognitive impairment risk.

Area of Science:

  • Cardiology
  • Neurology
  • Nephrology

Background:

  • Cardiometabolic and renal health profiles may influence cognitive benefits from intensive blood pressure (BP) lowering.
  • Previous studies have not fully explored this interaction.

Purpose of the Study:

  • To investigate whether participants with varying cardiometabolic renal health profiles experience comparable cognitive benefits from intensive BP-lowering treatment.
  • To analyze the association between intensive BP management and cognitive outcomes across different health profiles.

Main Methods:

  • Post hoc analysis of the Systolic Blood Pressure Intervention Trial (SPRINT).
  • Derived cardiometabolic renal health profiles using baseline glucose, cholesterol, kidney function (eGFR, ACR), and cardiovascular disease history.
  • Categorized participants into favorable, intermediate, and poor profiles; assessed cognitive outcomes including probable dementia and mild cognitive impairment (MCI).

Main Results:

  • 8162 participants included; intensive BP lowering showed a reduced risk of MCI in those with favorable profiles (adjusted HR 0.64).
  • The largest absolute risk reduction for MCI was observed in the favorable profile group (adjusted ARD -3.05%).
  • A significant interaction was found on the absolute risk difference (ARD) scale (p=0.039), but not for other cognitive outcomes or adverse events.

Conclusions:

  • Intensive BP-lowering treatment demonstrated a trend towards greater absolute risk reductions for MCI in individuals with favorable cardiometabolic renal health.
  • These exploratory findings require validation in future studies to confirm the impact on cognitive health across diverse patient profiles.
Abstract

Keywords:
blood pressure‐lowering treatmentcardiometabolic renal health profilemild cognitive impairmentprobable dementia

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