“Lower Your Blood Pressure Like This – And Slash Dementia Risk by 15% (Huge New Study)”
- A net reduction in systolic blood pressure of 22.0 mm Hg (95% CI: 20.6–23.4) and diastolic of 9.3 mm Hg (95% CI: 8.7–10.0) compared to usual care.
- The primary outcome—all-cause dementia—was significantly lower in the intervention group, with a risk ratio of 0.85 (95% CI: 0.76–0.95; P=0.0035), translating to a 15% relative reduction.
- In absolute numbers, dementia occurred in 4.59% of the intensive group versus 5.40% in usual care.
- For the secondary outcome of cognitive impairment without dementia (often called mild cognitive impairment or CIND), there was a 16% relative reduction (risk ratio approximately 0.84 in combined analyses).
- Notably, serious adverse events were actually less common in the intervention group (risk ratio 0.94; P=0.0006), suggesting the approach was safe and well-tolerated.
The study was led by researchers including Yingxian Sun from the First Hospital of China Medical University in Shenyang, along with collaborators like Jiang He from UT Southwestern Medical Center, and published in Nature Medicine in April 2025 (online April 21, 2025; DOI: 10.1038/s41591-025-03616-8). It was registered on ClinicalTrials.gov as NCT03527719.This trial stands out for several reasons: it was conducted in a real-world, resource-limited rural setting; used community-based health workers for delivery (making it scalable and cost-effective); and focused on primary prevention of dementia in a population starting with relatively high untreated hypertension. While previous trials like SPRINT showed benefits for mild cognitive impairment, this is one of the first large studies to demonstrate a clear, statistically significant reduction in all-cause dementia risk through blood pressure lowering alone.The researchers also noted potential added benefits from specific medication classes commonly used in the protocol, such as calcium channel blockers (e.g., amlodipine) and angiotensin receptor blockers (ARBs, e.g., losartan or valsartan). These drugs may offer neuroprotective effects beyond just BP reduction—possibly by improving cerebral blood flow, reducing vascular inflammation, protecting the blood-brain barrier, or influencing amyloid/tau pathways—though the trial was not designed to isolate drug-specific effects.High blood pressure remains one of the most powerful modifiable risk factors for vascular contributions to cognitive impairment and dementia (VCID), as chronic hypertension damages small brain vessels, promotes white matter lesions, and accelerates neurodegeneration. By achieving tight control early and consistently, this approach appears to interrupt that cascade.The implications are profound: in an aging world facing a rising dementia epidemic, simple, affordable hypertension management—delivered through primary care and community workers—could become a cornerstone strategy for brain health preservation. It protects not only against heart attacks and strokes but also helps safeguard memory, thinking skills, and independence in later life. While more research is needed in diverse populations and longer-term follow-up, these findings strengthen calls to prioritize intensive BP targets (e.g., <130/80 mm Hg) in guidelines for hypertension, especially among those at risk for cognitive decline. For millions, keeping blood pressure in check may be one of the most practical, evidence-based ways to fight dementia today.
