A new study has revealed that effectively treating high blood pressure significantly lowers the risk of developing cognitive impairment and dementia. The Chinese study involved participants who had untreated hypertension at the start of the study. The researchers found that by making the necessary lifestyle changes and using medications to manage high blood pressure, cognitive impairment risk dropped by 16% and dementia risk dropped by 15% over the four year period. According to Jiang He, MD, PhD, the lead author of the study, “Our study is one of the first large-scale randomized controlled effectiveness trials to demonstrate a significant reduction in all-cause dementia associated with lowering blood pressure.” In this article, we will explore the link between high blood pressure and dementia risk in greater detail.
The Link Between High Blood Pressure and Dementia Risk
Previous studies have already indicated a strong connection between high blood pressure and dementia risk. However, there was not enough definitive evidence that supported blood pressure reduction for the prevention of dementia in patients with hypertension. For the new Chinese study, the researchers assessed 33,995 adults with untreated hypertension to examine how effective blood pressure intervention was at lowering dementia risk. All of the participants were 40 years of age or older, and the study was conducted in 326 villages across three provinces.
Under the guidance of physicians, trained community healthcare workers administered high blood pressure medications using an easy-to-follow plan for the intervention group. Their goal was to bring systolic blood pressure below 130 mm Hg and diastolic pressure below 80 mm Hg. They also provided basic training on monitoring blood pressure at home and how to make the necessary lifestyle changes. These changes included restricting sodium intake, limiting alcohol consumption, and weight loss. In the usual care group, the participants were trained in blood pressure management and their blood pressure measurements were taken during visits to the clinic.
In the intervention group, SBP lowered from 157.0 to 127.6 mm Hg after 48 months. When it came to the usual care group, SBP lowered from 155.4 to 147.7 mm Hg, and DBP dropped from 87.2 to 81.0 mm Hg. Even after adjusting for the primary risk factors for dementia, these associations remained significant. The effectiveness of lowering high blood pressure remained consistent across all the subgroups, whether defined by sex, age, history of tobacco use, BMI, education level, and fasting plasma glucose. Adverse events were also found to be substantially lower in the intervention group.
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Perspectives From the Experts
Many experts consider this a landmark study due to the robust effect observed and the large sample size of participants. They regard it as a “wake-up call” that resting high blood pressure can protect both the heart and the brain. The link between high blood pressure and dementia risk has become increasingly apparent. According to a professor of clinical pharmacology at Queen Mary University of London, Mark Caulfield, MD, the study showed that “optimizing blood pressure control convincingly reduces risk of dementia.” Furthermore, he considers it a major advancement in the prevention of dementia and believes it will “transform global blood pressure guidance and prevention strategies.”
While 15% may not seem that significant, many health experts believe it could substantially reduce much suffering and healthcare costs if implemented among those with untreated high blood pressure. However, some experts do feel that the follow-up period of four years was too short. They feel it is necessary to see if the risk reduction continues after that period. They also would like to see if other populations receiving the same treatment experienced similar effects. If this proves to be true, treating people’s high blood pressure to prevent dementia could be recommended globally.
While the study cannot tell us whether these benefits will be enjoyed after four years, the results are still encouraging. The fact that the trial was carried out by nonphysician workers offers promise, especially considering that many rural regions don’t have access to trained physicians. This means that treating high blood pressure in these areas can still be accomplished if nonphysicians are involved, lowering the need for access to doctors. This will make treatments more easily accessible and more affordable for those who need them. The study was published in Nature Medicine on the 21st of April, 2025.
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