SPRINT-MIND (Intensive BP & Cognition)

Design

The SPRINT-MIND sub-study followed 9,361 SPRINT participants for incident probable dementia and mild cognitive impairment (MCI), allocated to intensive (target SBP <120) or standard (<140) BP control.

Findings

• Probable dementia: 17% relative reduction (not statistically significant by pre-specified threshold).
• Mild cognitive impairment: 19% relative reduction (statistically significant).
• Composite MCI or dementia: 15% relative reduction.

Why it matters

SPRINT-MIND was the first large RCT to show that modifying a cardiovascular risk factor reduces incident cognitive impairment. The reduction in MCI — the actionable pre-dementia state — supports earlier and more aggressive BP control as a dementia-prevention strategy.

The non-significant dementia result is likely a statistical power issue combined with the trial ending earlier than originally planned for mortality benefit.

Implications

• Reinforces hypertension as one of the larger modifiable dementia risk factors (Lancet Commission).
• Implies that the BP-cognition relationship has a treatment effect, not just association.
• Supports starting BP treatment earlier and targeting lower in adults at elevated cognitive risk.

Related entries

SPRINT, Cognitive decline, Hypertension, FINGER.