Yeah, I mean, so observational studies have long looked at this question about hypertension and dementia and cognitive decline. And there’s been a little bit of a mixed picture if you look back in the literature about, you know, some studies suggesting that there’s quite a straightforward relationship between high blood pressure, the higher blood pressure, higher the risk for dementia and cognitive decline...
Yeah, I mean, so observational studies have long looked at this question about hypertension and dementia and cognitive decline. And there’s been a little bit of a mixed picture if you look back in the literature about, you know, some studies suggesting that there’s quite a straightforward relationship between high blood pressure, the higher blood pressure, higher the risk for dementia and cognitive decline. And other studies have hinted at, well, maybe it’s not so simple. Maybe there’s more complex effects. So the question about the optimal blood pressure for cognitive health in older adults may actually be higher than we thought before but there’s all, you know, observational studies are useful and they show some trends but what’s come out more recently are, you know, prospective randomized trials looking specifically at people who have achieved certain blood pressure goals and their risk for cognitive decline in dementia. So systematic reviews looking at these data do show that achievement of lower blood pressure goals, like in the 130-80 range, and even aiming for lower if possible, does lower the risk for mild cognitive decline, which is a precursor and is the thing that appears first in the detectable earlier before dementia. As you might imagine, dementia, there’s a long ramp towards dementia, meaning it can take a long time to detect the incidence or the onset, new onset of dementia in people who didn’t have it at the beginning. So in randomized trials, they don’t always follow people for that length of time. So some of them have looked at mild cognitive impairment and others have looked at dementia as well. And as the meta-analyses and systematic reviews have pooled studies of similar design with similar outcomes and interventions, they’re seeing a definite signal showing that lower blood pressure will lower the risk for dementia, as well as mild cognitive impairment.
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