Age-related cognitive changes may be reduced with intensive blood pressure control

Written by Ebony Torrington (Future Science Group)

Researchers from the NIH (MD, USA) have used MRI scans to image the brains of hundreds of participants in the Systolic Blood Pressure Intervention Trial (SPRINT). The study demonstrated that in order to slow the accumulation of white matter lesions, it is more effective to intensively control a person’s blood pressure compared to the standard care of high blood pressure.
The results have been published in the Journal of the American Medical Association.

“These initial results support a growing body of evidence suggesting that controlling blood pressure may not only reduce the risk of stroke and heart disease but also of age-related cognitive loss,” explained Walter J Koroshetz (National Institute of Neurological Disorders and Stroke [NINDS]; MD, USA). “I strongly urge people to know your blood pressure and discuss with your doctors how to optimize control. It may be a key to your future brain health.”

Within the clinical trial (SPRINT Memory and Cognition in Decreased Hypertension [SPRINT MIND]) researchers examined whether controlling blood pressure levels could slow white matter lesion progression and aging brain disorders.

Originally, SPRINT allowed scientists to evaluate the effects of intensive blood pressure control against standard blood pressure control on cardiovascular health and mortality. Either standard treatment or intensive treatment was given to over 9300 adults who had a high risk for cardiovascular disease. Standard treatment lowered systolic blood pressure to below 140 mmHg (<140 mmHg) and intensive treatment lowered systolic blood pressure to less than 120 mmHg (<120 mmHg).

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SPRINT MIND, sub-supported by National Institute of Aging (NIA; MD, USA) and NINDS, allowed scientists to observe the effects the above treatments had on the brain. Through measuring cognitive function and using MRI scans to image the brains of a subset of patients from SPRINT, the researchers were able to test which treatment method was most effective. They compared brain scans of 449 participants that were enrolled at the beginning of SPRINT and 4 years later.

It was revealed that the average increase in total volume of white matter lesions within the intensive treatment group was 0.92cm3 compared with the standard treatment group, which was 1.45cm3.

“Intensive treatment significantly reduced white matter lesion accumulation in people who had a higher chance of experiencing this kind of damage because they had high blood pressure,” explained Clinton B Wright (NINDS).

To conclude, Lenore J Launer (NIA) said: “SPRINT MIND has produced promising initial results in the battle against the nation’s growing problem with aging brain disorders. Both the brain scans and the cognitive tests reinforce the potential benefits that intensive blood pressure management may have on the brain. We hope that these findings will become the foundation for future studies on how to protect the brain throughout a person’s life.”

In future, the researchers from SPRINT MIND hope to study how controlling blood pressure might affect the brain, including brain aging disorders and what might make people more responsive to treatment.

Sources: The SPRINT MIND Investigators for the SPRINT Research Group. Association of intensive versus standard blood pressure control with cerebral white matter lesions. JAMA doi:10.1001/jama.2019.10551 (2019) (Epub ahead of print); EurekAlert. Intensive blood pressure control may slow age-related brain damage. Press release: www.eurekalert.org/emb_releases/2019-08/nion-ibp080919.php