A recently published study involving researchers at Wake Forest Baptist Health shows a link between blood pressure and brain health. The SPRINT MIND project looks at the effect of treating hypertension in older adults and discovered how to possibly defend against what's called mild cognitive impairment.
WFDD's Bethany Chafin spoke with Wake Forest Baptist Health's Dr. Jo Cleveland on the findings of the research.
On the meaning of mild cognitive impairment:
Mild cognitive impairment is thought to be, let's say, a weigh station, if you will, between normal aging and dementia. So mild cognitive impairment is really characterized by patients that recognize they have a little memory problem. They can be proven to have a memory problem by how they perform on testing but their problems don't reach the level of affecting their daily function. So they're still able to drive and cook and shop and manage their money, all the things that you would normally have to do in a day. When something becomes dementia, it's when you begin to transition into a period of time where you aren't able to do those things for yourself. So you still have memory loss, but the difference is your function and your independence.
On the SPRINT MIND study's findings:
Unfortunately the primary finding was that lowering blood pressure to the level of 120 did not reduce the incidence of dementia. So the primary outcome was slightly disappointing. It did reduce the incidence by about 15 percent, but that wasn't enough to reach statistical significance. However, the risk of mild cognitive impairment and a composite of mild cognitive impairment and dementia did reach statistical significance, a reduction in 19 percent. So we feel like we finally have, for the first time ever, something that can be done to prevent the development of mild cognitive impairment. Knowing how ubiquitous dementia is and how much people fear it, now to have something in our back pocket that actually will help prevent it is very exciting.
On how this study differs from others:
The SPRINT study was different because it made an effort from the very beginning to be as inclusive as possible. At the end of the study we wanted physicians to be very confident that they could tell any patient that was sitting in front of them that lower blood pressure is better. So this study included a large number of patients over 75 years old, which is a group that's often been excluded in the past. And then it targeted very specifically to get 30 percent African-American and 10 percent Hispanic [patients]. Again, we wanted these results to be as generalizable as possible.
On ways in which this study was limited and what questions remain:
I think that a couple of questions are, of course, that we excluded patients that had diabetes and had had a stroke in the past. So we we aren't able to answer the question, "Should we lower blood pressure in that population as well?" And as you know there's a lot of people in those groups. So we can't answer that with any certainty. I think also patients that had some baseline dementia were eliminated from the get go. So would intensive treatment slow how quickly things progressed once they're diagnosed? We can't answer that question either. But by and large it's pretty well generalizable study.