Alzheimer’s: less cognitive impairment in people treated for hypertension

A large American study of 9,000 people found that patients treated intensively for hypertension had fewer mild cognitive deficits. These results suggest that treating hypertension could prevent dementia.

The history of Alzheimer’s disease is full of disappointed hopes, so the results of the Sprint Mind study published Monday in the journal of the American Medical Association (Jama) should be treated with caution. But the large number of participants in the study, and the good statistical quality of one of its results, make it essential in the fight against this incurable disease for the moment.

The trial was the first to discover a way to prevent memory or concentration problems in older people. “This is the first trial to have demonstrated an effective strategy for the prevention of age-related cognitive deficits,” writes Kristine Yaffe, a neurodegenerative disease specialist at the University of California at San Francisco, in an editorial published separately from the study in the Jama journal.
The clinical trial involved more than 9,000 adults over 50 years of age with hypertension. Half received treatment to lower their systolic pressure (the first of the two numbers that give blood pressure) to less than 140 mmHg, and the other half to less than 120, a more ambitious goal.

Intensive treatment of hypertension limits mild cognitive deficits. After a median follow-up of five years, physicians did not observe any difference between the two groups on a measure of “probable dementia”. However, the intensively treated group had significantly less mild cognitive impairment than the other group.

The study reinforces the idea that “what is good for the heart is good for the brain,” said Maria Carrillo, Scientific Director of the Alzheimer’s Association.
But this work does not provide any definitive conclusion that treating hypertension will prevent Alzheimer’s disease. Further studies are needed to clarify this relationship, which is why Maria Carrillo announced that the association will fund a two-year extension of the Sprint study to evaluate patients over a longer period of time as they reach older ages.

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