Intensive Blood Pressure Control Correlated With Slowed White Matter Lesion Accumulation

As published in JAMA, results of the SPRINT trial (NCT01206062), showed that intensive control of systolic blood pressure (goal 120 mm Hg) correlates with slowed accumulation of white matter lesions compared with standard treatment of hypertension (goal 140 mm Hg). In the SPRINT MIND substudy, 449 participants from the 2 treatment groups had cognitive testing and serial MRIs over 4 years of follow up. The mean volume of white matter lesions among people who had intensive blood pressure control was approximately half that seen in participants who had standard treatment (0.92 mL [95% CI, 0.69-1.14] vs 1.45 mL [95% CI, 1.21 to 1.70]). 

 “These findings on white matter lesions—primarily in the aggressive control of blood pressure—are encouraging as we continue to advance the science of understanding and addressing the complexities of brain diseases such as Alzheimer’s and related dementias,” said Richard J. Hodes, MD, director, NIH National Institute on Aging (NIA).

“These initial results support a growing body of evidence suggesting that controlling blood pressure may not only reduce stroke and heart disease risk, but also the risk of age-related cognitive loss,” said Walter J. Koroshetz, MD, director, NIH National Institute of Neurological Disorders and Stroke (NINDS). “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.”

Initial results from the SPRINT trial had shown that 3.3 years of intensive blood pressure control significantly reduced death and cardiovascular disease rates.