‘Intensive’ blood pressure treatment could reduce dementia risk: study

Intensive high blood pressure treatment may help lower the risk of dementia, according to a study from the American Heart Association.

The AHA study is the first to examine whether intensive blood pressure treatment — or trying to bring systolic pressure to 120 mm Hg or less — may slow or reverse structural changes to the brain’s perivascular spaces. These are areas around the blood vessels that clear toxins and other byproducts from the brain. They tend to get larger as people age or have more cardiovascular risk factors.

Researchers analyzed MRI scans for 243 people with high blood pressure who had intensive blood pressure treatment, and 199 people who had standard treatment (systolic blood pressure goal of 140 mm Hg).

When the study began, the volume of perivascular spaces was similar among participants in both blood pressure treatment groups. After almost 4 years of high blood pressure treatment, the volume had decreased "significantly" in the intensive treatment group. There were no changes in the standard group.

A doctor measures a pregnant mother's blood pressure at the obstetrics clinic at Huzhou People's Hospital in East China's Zhejiang province, Jan 20, 2023. (Photo credit should read CFOTO/Future Publishing via Getty Images)

A previous study, the SPRINT-MIND trial, had already shown that intensive blood pressure treatment can slow cognitive impairment, but this study found that it may also help to reverse the negative effects of high blood pressure in the brain.

"While not yet proven, the implication is that the intensive systolic blood pressure lowering may eventually be associated with better clearance of brain toxins and metabolic by-products and thus, provide a better chance to maintain brain health," said Dr. Philip B. Gorelick, a neurology professor and chair of the AHA’s Stroke Brain Health Science Subcommittee. Dr. Gorelick was not involved in the study.

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The study will be presented at the American Stroke Association’s International Stroke Conference, which takes place Feb. 8-10 in Dallas.

What is considered high blood pressure?

According to the American Heart Association, normal blood pressure is below 120/80 mm Hg. For adults, if systolic pressure (the top number) is 120 to 129 mm Hg, and diastolic pressure is less than 80 mm Hg, this is classified as elevated blood pressure.

High blood pressure is a systolic pressure of 130 mm Hg or higher, or a diastolic pressure of 80 mm Hg or higher, that stays high over time.