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Time in Target Systolic Blood Pressure Range and Cognitive Outcomes in Hypertension

Among participants with hypertension in the Systolic Blood Pressure Intervention Trial (SPRINT), time in target range (TTR) was a significant predictor of the risk of probable dementia, a secondary analysis indicates. The suggests “that TTR could be used as a practical metric of [blood pressure (BP)] control to evaluate the risk of dementia in older adults,” the authors conclude.

The analysis compared systolic blood pressure (SBP) targets of <120 mm Hg (intensive) and <140 mm Hg (standard) among patients with hypertension and high cardiac risks. Based on target ranges of 110 to 130 mm Hg in the intensive treatment arm and 120 to 140 mmHg in the standard treatment arm, the investigators found: “A total of 7,965 patients with the mean (SD) age of 68.0 (9.2) years were included, and 35% were female. Patients with higher TTR were younger, more likely to be male and take <3 BP-lowering agents. Compared to the last quartile, the first quartile of TTR was significantly associated with a higher risk of probable dementia (HR: 1.74; 95% CI: 1.22–2.46; P = 0.002) and the composite of probable dementia or mild cognitive impairment (HR: 1.26; 95% CI: 1.03–1.55; P= 0.025). The risk of probable dementia and the composite outcome increased with per quartile decrease of TTR (HR: 1.18; 95% CI: 1.06–1.30; P = 0.002 and HR: 1.07; 95% CI: 1.00–1.14; P = 0.036). Sensitivity analyses showed similar results after adjusting mean SBP during the first 3-month follow-up.”

Source: Journal of the American Geriatrics Society