• Posted January 27, 2025

Locking Down Blood Pressure Protects Brain Health

Maintaining tight control over blood pressure for even a short while can provide lasting benefits for seniors’ brain health, a new clinical trial says.

People had lower risk of mild cognitive impairment or dementia after keeping their blood pressure around 120 systolic for three and a half years, according to results published recently in the journal Neurology. (Systolic pressure, the top number in a blood pressure reading, measures the pressure in arteries when the heart pumps blood.)

What’s more, this reduced risk stayed with seniors long after they stopped such intense blood pressure treatment.

“Our study shows that intensive blood pressure control is an important strategy in the prevention of cognitive impairment, a major cause of loss of independence in older adults,” said senior researcher Dr. Jeff Williamson, a professor of gerontology and geriatric medicine at Wake Forest University School of Medicine in Winston-Salem, N.C.

“Lowering your blood pressure to more aggressive targets can improve the quality of life and extend active life for individuals with hypertension,” Williamson added in a news release.

The new study is the latest from a landmark clinical trial which, in 2015, reported that intensive blood pressure management reduced risk of heart disease and death by 30% to 40% in people with high blood pressure.

The trial -- called the Systolic Blood Pressure Intervention Trial, or SPRINT -- compared the health of people whose blood pressure was lowered to 120 systolic against others whose target was 140 systolic.

In 2019, further results from SPRINT showed a significantly reduced risk of mild cognitive impairment for up to five years following a period of intensive blood pressure control.

These latest findings from SPRINT followed patients for even longer, at least seven years, and found that the brain benefits of blood pressure control are indeed long-lasting.

The new paper reports on more than 7,000 participants from the initial trial who could be re-contacted. These folks took part in cognitive testing to check their brain function.

People who had gotten intensive blood pressure treatment during the trial were 13% less likely to have mild cognitive impairment and 11% less likely to have either mild cognitive impairment or dementia, compared with those whose blood pressure target was higher, researchers report.

“Over a median of almost seven years of follow-up, we observed that the previously reported statistically significant reduction in the rate of cognitive impairment …was maintained,” the researchers wrote.

“It is important to remember that participants randomized to intensive treatment underwent an average of just 3.3 years of intervention, after which the same level of intensive treatment of hypertension was generally not maintained,” they added.

“Thus, these data support intensive blood pressure treatment as an important strategy for the prevention of cognitive impairment and suggest some degree of persistent benefit on the development of cognitive impairment from even a few years of intensive treatment,” the researchers concluded.

Current blood pressure guidelines put normal blood pressure at 120 or less, elevated at 120 to 129, and high blood pressure at 130 or more. Leading heart health groups set these guidelines in 2017 based in part on the first results from SPRINT. 

More information

Harvard Medical School has more on blood pressure and the brain.

SOURCE: Wake Forest University, news release, Jan. 21, 2025