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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.

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


: 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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