Intensive blood pressure control and risks of cognitive outcomes in patients with new-onset orthostatic hypotension.
Background Orthostatic hypotension (OH) increases the risk of dementia. Although intensive blood pressure (BP) lowering may have cognitive benefits regardless of baseline OH status, its effects in participants who develop OH during intervention remain unknown. Methods Participants of the Systolic Bl...
| Publicado en: | Age & Ageing Vol. 55; no. 1; pp. 1 - 10 |
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| Autores principales: | , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Jan2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=192513131&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 192513131 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Jan2026 vid: 55 iid: 1 pid: 622 pub: Oxford University Press / USA artinfo: ui: 192513131 10.1093/ageing/afag005 ppf: 1 ppct: 9 formats: tig: atl: Intensive blood pressure control and risks of cognitive outcomes in patients with new-onset orthostatic hypotension. aug: au: Wang, Siyu Wang, Jingya Wang, Yueyue Xu, Xiaoli Gu, Haoqing Xie, Wanting Cai, Le Zhang, Junheng Wang, Tiange Zhao, Zhiyun affil: Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, ChinaNational Clinical Research Center for Metabolic Diseases (Shanghai), Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China Lifecycle Health Management Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China College of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China su: Randomized controlled trials Dementia risk factors Cognition disorder risk factors Risk assessment Data analysis T-test (Statistics) Research funding Frail elderly Antihypertensive agents Treatment effectiveness Chi-squared test Descriptive statistics Kaplan-Meier estimator Log-rank test Statistics Orthostatic hypotension Blood pressure Data analysis software Proportional hazards models Evaluation Disease complications sug: subj: Randomized controlled trials Pharmaceutical and medicine manufacturing Dementia risk factors Cognition disorder risk factors Risk assessment Data analysis T-test (Statistics) Research funding Frail elderly Antihypertensive agents Treatment effectiveness Chi-squared test Descriptive statistics Kaplan-Meier estimator Log-rank test Statistics Orthostatic hypotension Blood pressure Data analysis software Proportional hazards models Evaluation Disease complications keyword: blood pressure blood pressure regulation copyrightHolder:British Geriatrics Society copyrightYear:2026 dementia https://dx.doi.org/10.1093/ageing/afag005 inLanguage:en intensive blood pressure control mild cognitive impairment minimal cognitive impairment older people orthostatic hypotension probable dementia publisher:Oxford University Press randomization sameAs:https://pubmed.ncbi.nlm.nih.gov/41609319/ sprint trial systolic blood pressure blood pressure blood pressure regulation copyrightHolder:British Geriatrics Society copyrightYear:2026 dementia https://dx.doi.org/10.1093/ageing/afag005 inLanguage:en intensive blood pressure control mild cognitive impairment minimal cognitive impairment older people orthostatic hypotension probable dementia publisher:Oxford University Press randomization sameAs:https://pubmed.ncbi.nlm.nih.gov/41609319/ sprint trial systolic blood pressure ab: Background Orthostatic hypotension (OH) increases the risk of dementia. Although intensive blood pressure (BP) lowering may have cognitive benefits regardless of baseline OH status, its effects in participants who develop OH during intervention remain unknown. Methods Participants of the Systolic Blood Pressure Intervention Trial (SPRINT) were randomised to either intensive treatment (systolic BP target <120 mmHg) or standard treatment (systolic BP target <140 mmHg). This post hoc analysis defined new-onset OH as a systolic BP reduction ≥20 mmHg and/or a diastolic BP reduction ≥10 mmHg from a seated to a standing position at any follow-up visit during intervention. The primary outcome was probable dementia. Other outcomes included mild cognitive impairment (MCI), and a composite of probable dementia or MCI. Results Amongst 7911 participants without OH at baseline (representing 84.5% of randomised participants in SPRINT; mean age, 67.7 years; 34.7% women), 1264 (16.0%) developed new-onset OH during intervention. Intensive treatment was associated with a lower risk of probable dementia (HR, 0.76; 95% CI, 0.58 to 0.98) amongst participants without new-onset OH, but with a higher risk (HR, 2.39; 95% CI, 1.33 to 4.32) amongst participants with new-onset OH. No significant association was observed between intensive treatment and MCI, or the composite outcome in participants with new-onset OH. Conclusions The occurrence of OH requires close monitoring, with caution for potential cognitive adverse effects during ongoing intensive BP-lowering treatment. Validation of current findings in studies with justified methodological designs is warranted. Registration URL: ClinicalTrials.gov ; Unique Identifier: NCT01206062. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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