Among patients with high blood pressure, intensive blood pressure control was linked to a smaller increase in brain white matter lesions (a marker of small vessel disease and a risk factor for dementia) compared to standard blood pressure control, although the difference was small.
Hypertension is a risk factor for developing white matter lesions. This analysis is a substudy of a randomized clinical of 449 patients with high blood pressure who had initial brain magnetic resonance imaging (MRI) and a follow-up MRI after four years.
Researchers report intensive systolic blood pressure control (goal of less than 120 mm Hg) was associated with a smaller increase in white matter lesion volume compared with standard treatment (goal of less than 140 mm Hg).
Limitations of the study include the relatively short duration of the intervention and follow-up. Given the limited size of this study, it's also not possible to correlate changes in brain structure with dementia occurrence.
Authors: R. Nick Bryan, M.D., Ph.D., University of Texas at Austin, and coauthors (doi:10.1001/jama.2019.10551)
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