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Abstract: TH-PO675

Blood Pressure Lowering and Cognition: A Systematic Review and Meta-Analysis

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Gupta, Aditi, University of Kansas Medical Center, Kansas City, Kansas, United States
  • Perdomo, Sophy, University of Kansas Medical Center, Kansas City, Kansas, United States
  • Beddhu, Srinivasan, University of Utah School of Medicine, Salt Lake City, Utah, United States
  • Billinger, Sandra, KU Medical Center, Kansas City, Kansas, United States
  • Burns, Jeffrey M., University of Kansas School of Medicine, Kansas City, Kansas, United States
  • Gronseth, Gary, University of Kansas Medical Center, Kansas City, Kansas, United States
Background

Hypertension is a known risk factor for developing cognitive impairment and dementia, both vascular dementia and Alzheimer’s disease. Here we present the results of our systematic review of the effect of lowering of blood pressure on cognition.

Methods

We conducted a systematic review and meta-analysis of randomized placebo-controlled trials with a pre-specified objective outcome of cognition, and with pharmacological interventions to lower blood pressure for at least 12 months in adults > 60 years. We searched MEDLINE, CENTRAL and The Cochrane Library (inception to May 2019). Two independent reviewers assessed trial quality and extracted data. Since the analyzed outcomes were different in the selected studies, we standardized these outcomes by calculating Cohen’s D (SMD).

Results

Our initial search identified 2022 records. 1846 abstract were reviewed after removing duplicate records and out of these, 28 full-text articles pulled which met above inclusion criteria. Ten trials including 31,357 participants were included in the final analysis. The duration of the studies ranged from 1 year to median of 5.11 years. Fig 1 shows internal validity of the included studies. Fig 2 shows the forest plot with the effect on cognition (standardized mean difference with 95% confidence interval). The net standardized mean difference for change in cognition was -0.041 (CI -0.076, -0.005) indicating a positive effect on cognition with lowering of blood pressure. I squared was 0% indicating minimal heterogeneity.

Conclusion

Although the overall effect is small, current data indicates that pharmacological lowering of blood pressure in older adults without prior cerebrovascular events slows cognitive decline.

Funding

  • Other NIH Support