JAMA Neurology-Intensive blood pressure therapy, with limited impact on the outcome changes in the brain

Three large trials: systolic blood pressure Intervention Trial (SPRINT), control diabetes, heart vascular risk operations (ACCORD) trial blood pressure and strengthen the standard flow and blood pressure to prevent the elderly functional decline (INFINITY) test

However, the impact of intensive treatment on other mechanistic markers of cognitive impairment and dementia remains to be explored

However, it is not clear that this may be a direct impact on AD-related neurodegeneration or combined vascular pathology

Both ACCORD and SPRINT showed that compared with standard treatment, the total brain volume (TBV) of intensive treatment had a small but statistically significant decrease, although it is not clear to what extent these differences reflect atrophy and hydration status.

The study is a sub-study of the Systolic Intervention Trial (SPRINT MIND), which is a multicenter randomized clinical trial that compares the effects of two different antihypertensive strategies

Intervention: Participants were randomly assigned to a systolic blood pressure target of less than 120 mmHg (intensive treatment: n = 356) or less than 140 mmHg (standard treatment: n = 317)

The main clinical outcomes: changes in hippocampal volume, measurement of AD area atrophy, posterior cingulate cerebral blood flow, and average anisotropy of the cingulate tract

Among the 673 recruited patients with baseline MRI (mean [SD] age, 67.

In the intensive treatment group, the average hippocampal volume decreased from 7.

The important significance of this study is that it is found that compared with standard treatment, intensive treatment is related to a small decrease in hippocampal volume, but it is statistically significant, which is consistent with the observation that intensive treatment is related to a larger decrease in total brain volume