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  • Intensive systolic BP...

Intensive systolic BP treatment has significant cognitive benefits in mild cognitive impairment or dementia

Written By : Dr.Niharika Harsha B |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-05-22T10:30:59+05:30  |  Updated On 22 May 2023 1:05 PM IST
Intensive systolic BP treatment has significant cognitive benefits in mild cognitive impairment or dementia
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The secondary analysis of the SPRINT trial revealed that in a monotonic pattern patients with a higher baseline projected risk of probable dementia or amnestic mild cognitive impairment had significant absolute cognitive improvement with intensive vs conventional SBP therapy. The study results were published in the journal JAMA Network Open.

In the SPRINT trial, intensive (systolic blood pressure [SBP] goal <120 mm Hg) vs standard (SBP goal <140 mm Hg) treatment reduced the risk of a composite outcome of mild cognitive impairment (MCI) and probable dementia, in addition to cardiovascular disease (CVD) and all-cause mortality. Detecting patient characteristics associated with the greatest magnitude of cognitive benefit from intensive vs standard SBP treatment may help prioritize patients. Intensive vs standard treatment to lower systolic blood pressure (SBP) reduces the risk of mild cognitive impairment (MCI) or dementia but the magnitude of cognitive benefit likely varies among patients. Hence researchers conducted a study to estimate the magnitude of the cognitive benefit of intensive vs standard systolic BP (SBP) treatment.

Also Read: Obesity associated with lower use of RBC transfusions in cardiac surgery

About 9361 randomized clinical trial participants 50 years or older with high cardiovascular risk but without a history of diabetes, stroke, or dementia were followed up. The main intervention was the Systolic blood pressure treatment to an intensive (<120 mm Hg) vs standard (<140 mm Hg) target. A composite of adjudicated probable dementia or amnestic MCI was the primary outcome of the measurement.

Key findings:

  • A total of 7918 SPRINT participants were included in the analysis.

Group

Number

Age

gender

ethnicity

Intensive treatment group

3989

mean [SD] age, 67.9 [9.2] years

2570 [64.4%] men

1212 [30.4%] non-Hispanic Black

Standard Treatment group

3929

mean [SD] age, 67.9 [9.4] years

2570 [65.4%] men

1249 [31.8%] non-Hispanic Black

  • There were 765 and 828 primary outcome events in the intensive treatment group and standard treatment group, respectively, over a median follow-up of 4.13 (IQR, 3.50-5.88) years.
  • Older age, Medicare enrollment, and higher baseline serum creatinine level were associated with a higher risk of the primary outcome, while better baseline cognitive functioning and active employment status were associated with a lower risk of the primary outcome.
  • The risk of the primary outcome by treatment aim was properly assessed based on similar projected and observed absolute risk differences.
  • Across the whole range of estimated baseline risk, higher baseline risk for the main outcome was linked with the greater benefit of intensive vs standard therapy.

Thus, the researchers concluded that a higher baseline estimated risk of amnestic MCI or probable dementia was associated with greater absolute benefit from intensive (<120 mm Hg) compared with standard (<140 mm Hg) SBP treatment.

Furthermore: Ghazi L, Shen J, Ying J, et al. Identifying Patients for Intensive Blood Pressure Treatment Based on Cognitive Benefit: A Secondary Analysis of the SPRINT Randomized Clinical Trial. JAMA Netw Open. 2023;6(5):e2314443. doi: 10.1001/jamanetworkopen.2023.14443

JAMA Network OpenJAMASPRINT trialBlood pressure managementMedicineCardiology
Source : JAMA Network Open
Dr.Niharika Harsha B
Dr.Niharika Harsha B

    BDS, MDS

    Dr.Niharika Harsha B (BDS,MDS) completed her BDS from Govt Dental College, Hyderabad and MDS from Dr.NTR University of health sciences(Now Kaloji Rao University). She has 4 years of private dental practice and worked for 2 years as Consultant Oral Radiologist at a Dental Imaging Centre in Hyderabad. She worked as Research Assistant and scientific writer in the development of Oral Anti cancer screening device with her seniors. She has a deep intriguing wish in writing highly engaging, captivating and informative medical content for a wider audience. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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