Do you recommend performing cognitive testing in the clinic to determine the blood pressure target in patients 80 years or older?

SPRINT-MIND helps to answer this question. The total number of individuals developing dementia (the primary outcome in SPRINT-MIND) was fewer then expected after a median intervention period of only 3.3 years. This made SPRINT-MIND underpowered to detect the effects of intensive BP reduction on developing dementia. The low power to identify differences in incident dementia likely resulted from stopping the larger trial (SPRINT) early for benefit in all-cause mortality.

However, mild cognitive impairment (a secondary outcome of SPRINT-MIND) occurred less in the SBP < 120 mm Hg compared to the SBP < 140 mm Hg group. Results were similar in the subgroup of individuals > or = 75 years old. The average age for all study participants was 68 years ...