Cardiovascular–kidney–metabolic syndrome stage modifies the efficacy of intensive blood pressure control on cognitive outcomes: A post hoc analysis of SPRINT MIND
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Abstract INTRODUCTION Whether cardiovascular–kidney–metabolic (CKM) syndrome stage modifies cognitive benefits of intensive blood pressure (BP) control remains unclear. alz71623-sec-0010 METHODS This post hoc analysis of Systolic Blood Pressure Intervention Trial – Memory and Cognition in Decreased Hypertension (SPRINT MIND) classified participants into non‐advanced CKM (Stage 2,= 5,632) and advanced CKM (Stages 3–4,= 2,931). The primary outcome was probable dementia; secondary outcomes included mild cognitive impairment (MCI) and probable dementia or MCI composite. Treatment effects were evaluated using Cox models and generalized linear models. alz71623-sec-0020 RESULTS In non‐advanced CKM, intensive BP control reduced risks of probable dementia (hazard ratio [HR] 0.62, 95% confidence interval [CI] 0.46–0.85) and composite outcome (HR 0.74, 95% CI 0.62–0.89). No benefit was observed in advanced CKM (probable dementia: HR 1.15; composite: HR 0.97). Significant interactions between treatment and CKM stage were observed for probable dementia (= 0.009). alz71623-sec-0030 CONCLUSION Among patients with hypertension and non‐advanced CKM syndrome, intensive BP control was associated with lower risk of probable dementia, whereas no such benefit was observed in advanced CKM (see Graphical Abstract). alz71623-sec-0040 Highlights Cardiovascular–kidney–metabolic (CKM) syndrome stage modifies cognitive benefits of intensive blood pressure (BP) control Intensive BP control reduced dement
Abstract
Abstract INTRODUCTION Whether cardiovascular–kidney–metabolic (CKM) syndrome stage modifies cognitive benefits of intensive blood pressure (BP) control remains unclear. alz71623-sec-0010 METHODS This post hoc analysis of Systolic Blood Pressure Intervention Trial – Memory and Cognition in Decreased Hypertension (SPRINT MIND) classified participants into non‐advanced CKM (Stage 2,= 5,632) and advanced CKM (Stages 3–4,= 2,931). The primary outcome was probable dementia; secondary outcomes included mild cognitive impairment (MCI) and probable dementia or MCI composite. Treatment effects were evaluated using Cox models and generalized linear models. alz71623-sec-0020 RESULTS In non‐advanced CKM, intensive BP control reduced risks of probable dementia (hazard ratio [HR] 0.62, 95% confidence interval [CI] 0.46–0.85) and composite outcome (HR 0.74, 95% CI 0.62–0.89). No benefit was observed in advanced CKM (probable dementia: HR 1.15; composite: HR 0.97). Significant interactions between treatment and CKM stage were observed for probable dementia (= 0.009). alz71623-sec-0030 CONCLUSION Among patients with hypertension and non‐advanced CKM syndrome, intensive BP control was associated with lower risk of probable dementia, whereas no such benefit was observed in advanced CKM (see Graphical Abstract). alz71623-sec-0040 Highlights Cardiovascular–kidney–metabolic (CKM) syndrome stage modifies cognitive benefits of intensive blood pressure (BP) control Intensive BP control reduced dementia risk in non‐advanced CKM (hazard ratio [HR] 0.66) No cognitive benefit from intensive BP in advanced CKM stages (HR 1.26) Significant treatment × CKM stage interaction for dementia (= 0.005) CKM staging may guide individualized dementia prevention strategies bullet alz71623-list-0001 highlights