Dementia affects millions of people around the world and is a leading cause of death. As the global population ages, more families are impacted by memory loss, confusion, and the emotional weight of caring for loved ones with cognitive decline. With no cure in sight, doctors and scientists are now focusing on how to prevent dementia before it begins. One major risk factor stands out: high blood pressure.
A groundbreaking study from China, recently published in Nature Medicine, has found that reducing blood pressure can significantly lower the risk of dementia. Researchers from the China Medical University and other institutions launched a massive trial called the China Rural Hypertension Control Project Phase-3 (CRHCP-3). Their goal: test if intensive blood pressure management can help prevent dementia in people with hypertension.
The CRHCP-3 study followed 33,995 individuals over four years. Participants were from 326 villages in rural China and were all over the age of 40 with uncontrolled high blood pressure. Half received usual care. The other half received help from trained non-physician community healthcare providers (NPCHPs), who worked to lower patients’ blood pressure below 130/80 mm Hg using a step-by-step medication plan.
This approach worked. In the intervention group, systolic blood pressure dropped by 22 mm Hg, while diastolic dropped by 9.3 mm Hg compared to those who got standard care. That difference had major consequences. The intervention group had a 15% lower risk of all-cause dementia and a 16% lower risk of mild cognitive problems not yet considered dementia (CIND).
Professor Yingxian Sun, one of the study’s authors, emphasized the broader importance: “Dementia has become a global public health crisis due to its high prevalence, increased mortality, and the significant financial and emotional burdens it places on patients, caregivers, and society.”
Dementia is the fifth leading cause of death in the world, with around 2.4 million deaths each year. In 2019, about 57 million people had dementia. That number is expected to triple by 2050. The majority of cases will occur in low- and middle-income countries.
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Hypertension—or high blood pressure—is already known to be a major risk factor for heart disease and early death. But its impact on brain health is still being studied. Past research showed that untreated high blood pressure increased dementia risk, but the evidence wasn’t clear if treating it helped prevent dementia.
Several earlier studies tested blood pressure drugs but treated dementia only as a secondary concern. The SPRINT-MIND trial, for example, found a non-significant 17% decrease in dementia risk with tighter blood pressure control. That trial was smaller and shorter than CRHCP-3. Now, this new research gives stronger proof.
The CRHCP-3 trial tracked people for 48 months. Of the 33,995 participants, over 91% were followed up successfully. About 4.6% of those receiving intensive blood pressure care developed dementia, compared to 5.4% in the group receiving usual care. That may seem small, but for a disease with no cure, it’s a meaningful reduction.
Even more striking, mild cognitive impairment was seen in 17.2% of the intervention group, compared to 20.7% in the usual care group. When combining both outcomes (dementia or CIND), the risk was 16% lower. Also, the combination of dementia or death dropped by 14% in the intervention group.
This blood pressure-focused approach didn’t just help brain health. Serious medical issues were also less common. Hospitalizations and deaths were slightly lower in the intervention group. There were no increases in dangerous falls or fainting, which can be concerns when lowering blood pressure too aggressively.
In the intervention villages, trained community health workers followed a simple and effective system. They adjusted medications based on easy-to-follow guidelines, with support from doctors when needed. Patients in this group took an average of 3 medications by the end of the study. In contrast, those in the usual care group took just 1.2.
Common drugs used included ACE inhibitors (used by 50.3% of intervention patients), calcium channel blockers (86.8%), and diuretics (63.8%). Only 6.3%, 53.3%, and 10.8% of the usual care group, respectively, used those same drugs. Both groups had similar use of angiotensin-II receptor blockers.
Patients in the intervention group were also more consistent about taking their medications. Nearly 88% stuck with their treatment, compared to 66% in the usual care group. This difference in commitment may have helped drive the stronger results.
The results from the CRHCP-3 study point to a clear path forward. If more people with high blood pressure manage it well, especially in places with limited resources, the risk of dementia could fall worldwide.
“These findings provide additional motivation for patients with hypertension to reduce their blood pressure—not only to prevent cardiovascular disease, but also to lower their risk of dementia,” said Sun.
The team believes that future tools like big data and artificial intelligence may help doctors predict who is most at risk for dementia. This would allow even earlier and more targeted prevention strategies.
Importantly, the study’s benefits were seen across many different groups. It worked regardless of age, gender, weight, or smoking history. People with both high and low risk for heart disease saw improvements. This suggests that the approach can be used widely, not just for those at very high risk.
The researchers from China Medical University and their collaborators hope this trial inspires health systems around the world. By focusing on blood pressure, we may be able to protect the brain just as much as the heart.
Note: The article above provided above by The Brighter Side of News.
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