Effect of intensive blood pressure control on subtypes of mild cognitive impairment and risk of progression from SPRINT study.
J Am Geriatr Soc
; 70(5): 1384-1393, 2022 05.
Article
in En
| MEDLINE
| ID: mdl-34826341
ABSTRACT
BACKGROUND:
To examine the effect of intensive blood pressure control on the occurrence of subtypes of mild cognitive impairment (MCI) and determine the risk of progression to dementia or death.METHODS:
Secondary analysis of a randomized trial of community-dwelling adults (≥50 years) with hypertension. Participants were randomized to a systolic blood pressure (SBP) goal of <120 mm Hg (intensive treatment; n = 4678) or <140 mm Hg (Standard treatment; n = 4683). Outcomes included adjudicated MCI, MCI subtype (amnestic, non-amnestic, multi-domain, single domain), and probable dementia. Multistate survival models were used to examine transitions in cognitive status accounting for the competing risk of death.RESULTS:
Among 9361 randomized participants (mean age, 67.9 years; 3332 women [35.6%]), 640 participants met the protocol definition for MCI, with intensive treatment reducing the risk of MCI overall (hazard ratio [HR], 0.81 [95% confidence interval {CI}, 0.69-0.94]), as previously reported. This effect was largely reflected in amnestic subtypes (HR, 0.78 [95% CI, 0.66-0.92]) and multi-domain subtypes (HR, 0.78 [95% CI, 0.65-0.93]). An adjudication of MCI, as compared with normal cognitive function, substantially increased the probability of progressing to probable dementia (5.9% [95% CI 4.5%-7.7%] vs. 0.6% [95% CI 0.3%-0.9%]) and to death (10.0% [95% CI 8.3%-11.9%] vs. 2.3% [95% CI 2.0%-2.7%]) within 2 years.CONCLUSIONS:
Intensive treatment reduced the risk for amnestic and multi-domain subtypes of MCI. An adjudication of MCI was associated with increased risk of progression to dementia and death, highlighting the relevance of MCI as a primary outcome in clinical and research settings.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Dementia
/
Cognitive Dysfunction
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Hypertension
Type of study:
Clinical_trials
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Etiology_studies
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Guideline
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Risk_factors_studies
Limits:
Aged
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Female
/
Humans
Language:
En
Journal:
J Am Geriatr Soc
Year:
2022
Document type:
Article
Affiliation country:
United States
Publication country:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
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UNITED STATES OF AMERICA
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US
/
USA