Intensive BP-lowering strategy does not harm cognitive function

In Chinese hypertensive patients, lowering systolic blood pressure (BP) to a target of <120 mm Hg for 3 years appears to have no adverse effect on cognitive function, according to a study.

Researchers conducted a secondary analysis of a randomized controlled trial involving hypertensive patients with high cardiovascular risk in China. These patients had been randomly allocated to the group that received intensive treatment (systolic BP target <120 mm Hg) or the group that received standard treatment (systolic BP target <140 mm Hg). Treatment lasted a median of 3.4 years.

Cognitive function was evaluated using the Mini-Mental State Examination (MMSE) at baseline and the end of the study. Outcomes of interest were a change in MMSE score and investigator-reported probable dementia.

The study included 11,255 patients, of which 10,440 (92.8 percent) completed the follow-up. MMSE scores decreased by 0.54 points in the intensive arm vs 0.60 in the standard arm. The difference of 0.05 points (95 percent confidence interval [CI], −0.07 to 0.17) was not statistically significant.

Results were consistent across most subgroups (except for those defined by coronary heart disease and antiplatelet treatment) and robust across sensitivity analyses.

The incidence of probable dementia was low and precluded meaningful interpretation.

The findings support the safety to this treatment strategy for Chinese hypertensive adults at high cardiovascular risk.