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J Hypertens. 2018 Sep;36(9):1780-1787. doi: 10.1097/HJH.0000000000001829.

Blood pressure-lowering interventions to prevent dementia: a systematic review and meta-analysis.

Author information

1
Department of Neurology, Academic Medical Center, Amsterdam.
2
Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen.
3
Department of General Practice, Amsterdam Public Health Research Institute.
4
Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands.

Abstract

: Our objective was to study the preventive effect of lowering blood pressure (BP) by medication and/or lifestyle changes on incident all-cause dementia, Alzheimer's disease and vascular dementia. In this systematic review, we included randomized controlled trials with a BP-lowering intervention. Of the nine included trials, seven assessed the effect of antihypertensive medication and two of a lifestyle or combined intervention. In the intervention arm, 1041 out of 29 029 (3.6%) participants were diagnosed with dementia compared with 1090 out of 28 653 (3.8%) controls during a median follow-up of 3.9 years [range 2-10], resulting in a pooled risk ratio of 0.93 (95% confidence interval 0.84-1.02; I 16%). Three trials specified dementia subtypes, with no significant effect on Alzheimer's disease or vascular dementia. To conclude, lowering BP by medication and/or lifestyle changes did not lead to a significantly reduced risk of dementia. This appeared independent of dementia subtype.

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