Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Intensive BP Control & Risk of Probable Dementia

JAMA; 2019 Jan 28; SPRINT Mind Investigators

Among adults with hypertension, intensive blood pressure (BP) control did not significantly reduced the risk of probable dementia, a new study concluded. Researchers studied the effect of intensive vs standard BP control on probable dementia from a randomized clinical trial conducted at 102 sites in the US and Puerto Rico among adults aged ≥50 years with hypertension but without diabetes or history of stroke. Participants were randomized to a systolic BP goal of either <120 mm Hg (intensive treatment group; n=4,678) or <140 mm Hg (standard treatment group; n=4,638). The primary cognitive outcome was occurrence of adjudicated probable dementia. Among the details:

  • Among 9,361 randomized participants (mean age 67.9 years, 35.6% women), 8,563 (91.5%) completed at least 1 follow-up cognitive assessment.
  • Median intervention period was 3.34 years.
  • During a total median follow-up of 5.11 years, adjudicated probable dementia occurred in 149 participants in the intensive treatment groups vs 176 in the standard treatment group (7.2 vs 8.6 cases per 1,000 person-years).
  • Intensive BP control significantly reduced the risk of mild cognitive impairment and the combined rate of mild cognitive impairment or probable dementia.

Citation:

The SPRINT MIND Investigators for the SPRINT Research Group. Effect of intensive vs standard blood pressure control on probable dementia: A randomized clinical trial. JAMA. 2019;321(6):553–561. doi:10.1001/jama.2018.21442.

This Week's Must Reads

Acute Illness and Cannabis Use in Adults, Ann Intern Med; ePub 2019 Mar 26; Monte, et al

Pregnancy History and Risk of Miscarriage, BMJ; ePub 2019 Mar 20; Magnus, et al

Firearms Mortality Among US Schoolchildren, Am J Med; ePub 2019 Mar 25; Rubenstein, et al

Rapid Point of Care Test for Influenza, J Am Board Fam Med; 2019 Mar; Dale, et al

Sleep Disturbance and Chronic Pain Intensity, Clin J Pain; ePub 2019 Mar 25; Burgess, et al

Must Reads in Cardiology

Consumption of SSBs & Risk of Mortality, Circulation; ePub 2019 Mar 18; Malik, et al

Dietary Cholesterol or Egg Consumption & CVD, JAMA; 2019 Mar 19; Zhong, Van Horn, et al

Physical Activity & Incidence of CHD & CVD in Women, JAMA Netw Open; ePub 2019 Mar 15; LaCroix, et al

Intensive BP Control in Adults with Hypertension Who Smoke, JAMA Netw Open; ePub 2019 Mar 8; Scarpa, et al

Leisure-Time Physical Activity Across Adulthood, JAMA Netw Open; ePub 2019 Mar 8; Saint-Maurice, et al