NIH-funded researchers preview preliminary clinical trial results at AAIC suggesting aggressive blood pressure control may lower risk of cognitive impairment

What

Preliminary findings from a large clinical trial, the Systolic Blood Pressure Intervention Trial (SPRINT) Memory and Cognition IN Decreased Hypertension (SPRINT MIND) study will be presented at the Alzheimer’s Association International Conference in Chicago on July 25. The findings suggest that intensive lowering of blood pressure may reduce the risk of mild cognitive impairment (MCI) and the combined risk of MCI and dementia, but not dementia alone. The SPRINT MIND study was funded by the National Institutes of Health.

The participants in SPRINT were adults at high risk for cardiovascular disease and the study previously reported that aggressive blood pressure control reduced cardiovascular events and mortality. In addition to the reduction in the risk of cognitive impairment, the SPRINT MIND preliminary results also suggest that intensive blood pressure control significantly lowered increases in cerebral white matter abnormalities as seen on MRI among a subgroup of participants without diabetes. These abnormalities have been reported to increase the risk of cognitive impairment and dementia.

NIH spokespeople can provide important context about these preliminary findings including:

• Explaining the preliminary nature of these results, their limitations and the importance of peer review
• Sharing details about the SPRINT, SPRINT MIND and SPRINT Alzheimer’s, Senior and Kidney (ASK) studies
• Reviewing how a growing body of research has pointed to a link between hypertension-related cerebrovascular disease and dementia
• Describing NIH’s Mind Your Risks® health campaign to increase awareness of the link between vascular disease and brain health

Who

• Laurie Ryan, Ph.D., chief, Dementias of Aging Branch, Division of Neuroscience, NIA – NIA is one of the primary funders of SPRINT MIND and sole funder of the SPRINT ASK follow-up study
• Lawrence J. Fine M.D., DrPH, chief, Clinical Applications and Prevention Branch, Division of Cardiovascular Sciences, and Joni K. Snyder, clinical trials specialist, Clinical Applications and Prevention Branch, Division of Cardiovascular Sciences, NHLBI – NHLBI is the primary funder of SPRINT
• Clinton B. Wright, M.D., M.S., director, Office of Clinical Research, and Claudia S. Moy, Ph.D., program director, Office of Clinical Research, NINDS – SPRINT MIND funder and sponsor of the Mind Your Risks® public health campaign to increase awareness of the links between vascular and brain health
• Paul Kimmel, M.D., M.A.C.P., program director, Division of Kidney, Urologic, and Hematologic Diseases, NIDDK – SPRINT funder

NIH-funded researchers from the University of Pennsylvania, Philadelphia, and Wake Forest School of Medicine, Winston-Salem, North Carolina, will present preliminary data at an Alzheimer’s Association International Conference(link is external) (AAIC) press briefing in Chicago, July 25, 2018, 8 a.m. Central Time/9 a.m. Eastern Time. They will discuss two related abstracts which preview results that aim to directly address the link between hypertension-related cerebrovascular disease and dementia. In the first abstract, researchers from Wake Forest School of Medicine suggest that a systolic blood pressure target of <120 mmHg (compared to a target of <140 mmHg) may reduce the risk of mild cognitive impairment and the combined risk of MCI and dementia. For the second, researchers from the University of Pennsylvania suggest that the lower blood pressure target reduced the increase in total volume of cerebral white matter lesions on MRI scans.

How these results generalize to other high-risk populations or those without major cardiovascular risk awaits detailed analysis and publication of the final results in a peer-reviewed journal. It is anticipated that these findings will be submitted for peer-reviewed publication later this year.