Keeping a tighter rein on blood pressure in adults over 50 is desirable for brain health

Participants whose hypertension was more intensively managed had fewer lesions in the brain’s white matter

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SAN ANTONIO (April 21, 2023) — Intensive blood pressure treatment significantly reduces the risk of adverse cerebrovascular events such as stroke. New research from The University of Texas Health Science Center at San Antonio (UT Health San Antonio) shows evidence of how the brain benefits from consistently lower blood pressure.

The study, published March 1 in JAMA Network Open, is a follow-up analysis of the Systolic Blood Pressure Intervention Trial (SPRINT), a multicenter clinical trial that compared intensive systolic blood pressure control (target less than 120 mm Hg) versus standard control (target less than 140 mm Hg). SPRINT enrolled participants aged 50 or older with hypertension and without diabetes or a history of stroke.

Mohamad Habes, PhD

“Our study demonstrates that lowering systolic blood pressure to below 120 mm Hg is more effective in preserving brain health compared to standard treatment goals,” said corresponding author Mohamad Habes, PhD, assistant professor of radiology and director of the neuroimaging core at the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases. The Biggs Institute at UT Health San Antonio, in collaboration with The University of Texas Rio Grande Valley, is the state’s only National Institute on Aging-designated Alzheimer’s Disease Research Center (ADRC).

Patients receiving intensive blood pressure treatment showed reduced white matter lesions in frontal and posterior deep white matter, and improved blood flow, indicating better overall brain health, Habes said. White matter lesions are among the changes that can be associated with Alzheimer’s disease, non–Alzheimer’s disease cognitive impairment and advanced brain aging, he said.

Tanweer Rashid, PhD

The paper highlights that intensive blood pressure treatment can slow down vascular brain injury, potentially contributing to the preservation of cognitive function in older adults, said Tanweer Rashid, PhD, of the Biggs Institute’s neuroimage analytics laboratory and neuroimaging core.

“Our study shows that specific areas have greater benefit, representing sensitive regions to track in future trials evaluating small-vessel disease,” Rashid said.

The paper acknowledges the need for further research to determine the optimal blood pressure targets and treatment strategies for various population groups and to assess potential side effects of intensive blood pressure treatment, Habes said.

Association of Intensive Versus Standard Blood Pressure Control With Regional Changes In Cerebral Small Vessel Disease Biomarkers

Tanweer Rashid, PhD; Karl Li, MD, PhD; Jon B. Toledo, MD, PhD; Ilya Nasrallah, MD, PhD; Nicholas M. Pajewski, PhD; Sudipto Dolui, PhD; John Detre, MD; David A. Wolk, MD; Hangfan Liu, PhD; Susan R. Heckbert, MD, PhD; R. Nick Bryan, MD, PhD; Jeff Williamson, MD; Christos Davatzikos, PhD; Sudha Seshadri, MD; Lenore J. Launer, PhD; Mohamad Habes, PhD

The University of Texas Health Science Center at San Antonio (UT Health San Antonio), a primary driver for San Antonio’s $44.1 billion health care and biosciences sector, is the largest academic research institution in South Texas with an annual research portfolio of $360 million. Driving substantial economic impact with its six professional schools, a diverse workforce of 7,900, an annual operating budget of $1.08 billion and clinical practices that provide 2.6 million patient visits each year, UT Health San Antonio plans to add more than 1,500 higher-wage jobs over the next five years to serve San Antonio, Bexar County and South Texas. To learn about the many ways “We make lives better®,” visit

The Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases is dedicated to providing comprehensive dementia care while advancing treatment through clinical trials and research. The Biggs Institute is a National Institute on Aging (NIA)-designated Alzheimer’s Disease Research Center (ADRC). In addition to patient care and research, the Biggs Institute partners with the School of Nursing at UT Health San Antonio to offer the Caring for the Caregiver program.

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