Bosch J, O'Donnell M, Swaminathan B, Lonn EM, Sharma M, Dagenais G, Diaz R, Khunti K, Lewis BS, Avezum A, Held C, Keltai M, Reid C, Toff WD, Dans A, Leiter LA, Sliwa K, Lee SF, Pogue JM, Hart R, Yusuf S, HOPE-3 Investigators. Effects of blood pressure and lipid lowering on cognition: Results from the HOPE-3 study. Neurology. 2019 Feb 27; PubMed.

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  1. This study can also help to dispel the myth that, in older people, higher blood pressure is needed to provide sufficient blood flow to the brain, and that therefore blood pressure lowering may adversely affect cognitive function.

    It is clear in this study that BP lowering had no negative effect on cognitive or functional outcomes, also not in those with the highest BP at baseline (i.e., those at most risk of adverse effects of BP lowering, if it were true that their high BP was needed to maintain adequate CBF).

    As a side note, it is somewhat reassuring to see that of the initial cohort of almost 2,400, after almost six years only 16 people developed dementia (0.7 percent), and only four had to be institutionalized. Of course there are caveats due to the large drop-out with loss to follow-up, but still ...

    References:

    de Heus RA, de Jong DL, Sanders ML, van Spijker GJ, Oudegeest-Sander MH, Hopman MT, Lawlor BA, Olde Rikkert MG, Claassen JA. Dynamic Regulation of Cerebral Blood Flow in Patients With Alzheimer Disease. Hypertension. 2018 Jul;72(1):139-150. Epub 2018 May 29 PubMed.

    View all comments by Jurgen Claassen

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