Two US studies showed that more intensive blood pressure (BP) management was associated with less progression of cerebral small vessel ischemic diseaseand a greater decrease in total brain volume; BP patterns in midlife and late life may be associated with differing risks for incident dementia. The substudy of a randomized clinical trial of 449 hypertensive patients with longitudinal brain magnetic resonance imaging, intensive BP management to a target of less than 120 mm Hg, vs less than 140 mm Hg, was associated with a smaller increase in white matter lesion volume (0.92 cm3 vs 1.45 cm3) and a greater decrease in total brain volume (−30.6cm3 vs −26.9 cm3). Another prospective cohort study that included 4761 participants with 24-year follow-up and BP measurements at midlife and at late life, those with midlife and late-life hypertension (BP >140/90 mm Hg; hazard ratio, 1.49) and those with midlife hypertension and late-life hypotension (<90/60 mm Hg; hazard ratio, 1.62) had higher risk for incident dementia compared with those who remained normotensive. Both studies suggest the importance of optimizingBP management for dementia prevention. Source: https://jamanetwork.com/
