In an across the country research study, scientists utilized magnetic resonance imaging (MRI) to scan the brains of numerous individuals in the National Institutes of Health’s Systolic Blood Pressure Intervention Trial (SPRINT) and discovered that intensively managing an individual’s high blood pressure was more efficient at slowing the build-up of white matter sores than basic treatment of hypertension. The outcomes match a previous research study released by the exact same research study group which revealed that intensive treatment substantially reduced the possibilities that individuals established moderate cognitive disability.
“These initial results support a growing body of evidence suggesting that controlling blood pressure may not only reduce the risk of stroke and heart disease but also of age-related cognitive loss,” stated Walter J. Koroshetz, M.D., director of the NIH’s National Institute of Neurological Conditions and Stroke (NINDS). “I strongly urge people to know your blood pressure and discuss with your doctors how to optimize control. It may be a key to your future brain health.”
Brain white matter is comprised of billions of thin nerve fibers, called axons, that link the nerve cells with each other. The fibers are covered by myelin, a white fatty covering that secures axons from injury and speeds the circulation of electrical signals. White matter sores, which appear brilliant white on MRI scans, represent a boost in water material and show a range of modifications deep inside the brain, consisting of the thinning of myelin, increased glial cell responses to injury, leaking brain capillary, or numerous strokes. These modifications are related to hypertension, or “hypertension”.
As explained on the NIH’s Mind Your Threats site, a number of research studies have actually recommended that individuals who have high blood pressure have a higher opportunity of collecting white matter sores and likewise of experiencing cognitive conditions and dementia later on in life.
These observations were checked in a “gold standard” randomized scientific trial, called SPRINT Memory and Cognition in Reduced High Blood Pressure (MIND), which took a look at whether managing high blood pressure levels might avoid or slow white matter sore development and aging brain conditions. The outcomes were released on Aug. 13, 2019 in the Journal of the American Medical Association.
“These findings on white matter lesions – primarily in the aggressive control of blood pressure – are encouraging as we continue to advance the science of understanding and addressing the complexities of brain diseases such as Alzheimer’s and related dementias,” stated Richard J. Hodes, M.D., director of the NIH’s National Institute on Aging (NIA).
Introduced in 2010, the NIH-supported SPRINT effort at first made it possible for researchers to compare the impacts of basic versus intensive high blood pressure control on cardiovascular health and death. More than 9,300 grownups who were at least 50 years of ages and had a high danger for heart disease got either basic treatment, which reduced systolic high blood pressure, the very first of 2 numbers determined throughout a test, to less than 140 mm Hg (<140 mm Hg), or intensive treatment to lower the same pressure reading below 120 mm Hg (<120 mm Hg). In August 2015, NIH surprisingly ended the trial early after initial results showed that 3.3 years of intensive treatment significantly reduced the rates of death and cardiovascular disease.
The NIA and NINDS supported sub-study, SPRINT MIND, enabled scientists from 27 clinical sites to examine the effects these treatments had on the brain by measuring cognitive function and acquiring MRI scans on a subset of SPRINT participants. The researchers compared brain scans of 449 participants that were taken at enrollment and four years later. During this time, the average increase in total volume of white matter lesions on scans of the intensive treatment group was 0.92 cm3, which was less than the 1.45 cm3 seen on scans from the standard treatment participants.
“Intensive treatment significantly reduced white matter lesion accumulation in people who had a higher chance of experiencing this kind of damage because they had high blood pressure,” said Clinton B. Wright, M.S., M.D., director of the Division of Clinical Research at NINDS, and an author of the study.
“SPRINT MIND has produced promising initial results in the battle against the nation’s growing problem with aging brain disorders. Both the brain scans and the cognitive tests reinforce the potential benefits that intensive blood pressure management may have on the brain,” said Lenore J. Launer, Ph.D., a senior investigator in the NIA Laboratory of Epidemiology and Population Sciences and co-author of the paper. “We hope that these findings will become the foundation for future studies on how to protect the brain throughout a person’s life.”
In the future, SPRINT MIND researchers plan to look at how controlling blood pressure may affect the accumulation of white matter lesions in critical regions of the brain affected by aging brain disorders and what factors may make some people more responsive to treatment.