Cardiovascular–kidney–metabolic syndrome stage modifies the efficacy of intensive blood pressure control on cognitive outcomes: A post hoc analysis of SPRINT MIND
Zhongxiao Wang, Junyu Pei, Tienan Sun, Siqi Ge, Taoyang Wu, Yuzhe Yin, Haipeng Wang, Jialiang Yang, Keyang ZhengAbstract
INTRODUCTION
Whether cardiovascular–kidney–metabolic (CKM) syndrome stage modifies cognitive benefits of intensive blood pressure (BP) control remains unclear.
METHODS
This post hoc analysis of Systolic Blood Pressure Intervention Trial – Memory and Cognition in Decreased Hypertension (SPRINT MIND) classified participants into non‐advanced CKM (Stage 2, n = 5,632) and advanced CKM (Stages 3–4, n = 2,931). The primary outcome was probable dementia; secondary outcomes included mild cognitive impairment (MCI) and probable dementia or MCI composite. Treatment effects were evaluated using Cox models and generalized linear models.
RESULTS
In non‐advanced CKM, intensive BP control reduced risks of probable dementia (hazard ratio [HR] 0.62, 95% confidence interval [CI] 0.46–0.85) and composite outcome (HR 0.74, 95% CI 0.62–0.89). No benefit was observed in advanced CKM (probable dementia: HR 1.15; composite: HR 0.97). Significant interactions between treatment and CKM stage were observed for probable dementia ( p = 0.009).
CONCLUSION
Among patients with hypertension and non‐advanced CKM syndrome, intensive BP control was associated with lower risk of probable dementia, whereas no such benefit was observed in advanced CKM (see Graphical Abstract).