Hyperuricemia and its related diseases: mechanisms and advances in therapy

Blood Pressure And Dementia Risk Share Surprising Link, Study Suggests

Hypertension, or high blood pressure, is known to have a direct impact on heart attack and stroke risk — but a new study has revealed its surprising link to brain health.

In a large, randomized trial, researchers led by First Hospital of China Medical University discovered that "intensive blood pressure control" resulted in a 15% reduced dementia risk among participants and a 16% reduced risk of cognitive impairment.

The study included 33,995 people in rural China aged 40 or older who had "uncontrolled hypertension."

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The participants were divided into two groups. One received "usual care," while the other was assigned to "trained non-physician community healthcare providers" who prescribed "titrated antihypertensive medications."

Hypertension, or high blood pressure, is known to have a direct impact on heart attack and stroke risk — but a new study has revealed its surprising link to brain health. (iStock)

For the latter group, the medications helped them achieve a systolic blood pressure goal of <130 mm Hg and a diastolic blood pressure goal of <80 mm Hg, according to the study findings in Nature Medicine.

"The primary outcome of all-cause dementia was significantly lower in the intervention group than in the usual care group," the researchers wrote. 

They were also less likely to experience "serious adverse events."

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This was one of the first large-scale, randomized, controlled effectiveness trials to demonstrate a "significant reduction in all-cause dementia associated with lowering blood pressure," the researchers concluded.

There were some limitations of the study, the article acknowledged, including the absence of baseline and follow-up cognitive assessments. 

"The primary outcome of all-cause dementia was significantly lower in the intervention group than in the usual care group," the researchers wrote.  (iStock)

Dr. Bradley Serwer — an interventional cardiologist and chief medical officer at VitalSolution, an Ingenovis Health company that offers cardiovascular and anesthesiology services to hospitals — said this study presents an "intriguing approach" to addressing dementia in individuals with uncontrolled hypertension. 

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"Unlike studies performed in the United States, this study employed non-physicians to significantly reduce blood pressure in rural China through a 'cluster' blinding method," Ohio-based Serwer, who was not involved in the study, told Fox News Digital.

It would be beneficial to include baseline cognitive assessments of the patients and to identify the prevalence of Alzheimer's dementia within the communities, one doctor noted. (iStock)

"While the study can be subject to scrutiny, it raises a pertinent question: How crucial is modification of cardiovascular risk factors in the development of dementia?"

The primary medications used in the study to lower blood pressure were calcium channel blockers and angiotensin receptor blockers, Serwer noted. 

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"These commonly prescribed medications have been independently associated with a reduced risk of dementia, irrespective of the magnitude of blood pressure reduction they achieve," he said.

"This raises the possibility that the lower rates of dementia observed may be attributed to other beneficial effects of the medications rather than solely to blood pressure reduction."

This was one of the first large-scale, randomized, controlled effectiveness trials to demonstrate a "significant reduction in all-cause dementia associated with lowering blood pressure," the researchers said. (iStock)

To confirm the findings, Serwer said it would be beneficial to include baseline cognitive assessments of the patients and to identify the prevalence of Alzheimer's dementia within the communities.

"The most significant takeaway from this study is the profound importance of addressing blood pressure, cholesterol, smoking and sedentary lifestyles," the cardiologist said. 

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"By prioritizing these factors, we not only aim to prevent heart attacks and strokes, but also strive to enhance overall quality of life."

The study was supported by the National Key Research and Development Program of the Ministry of Science and Technology of China, Chinese Society of Cardiology Foundation, and the Science and Technology Program of Liaoning Province, China.

For more Health articles, visit www.Foxnews.Com/health

Fox News Digital reached out to the researchers for comment.

Melissa Rudy is senior health editor and a member of the lifestyle team at Fox News Digital. Story tips can be sent to melissa.Rudy@fox.Com.

Intensive Lowering Of Blood Pressure Tied To Lower Dementia Risk

High blood pressure earned its reputation as the silent killer by causing heart attacks, heart failure, and strokes.

It's also been a suspect in dementia. Some studies have hinted at a correlation between lower blood pressure and fewer dementia cases, but they were too small and too short to lend statistical significance to the link. It's also been noted that people with untreated high blood pressure carry a 42% higher risk of developing dementia. 

Now a new study published Monday in Nature Medicine reports that intensive blood pressure control lowered the risk of dementia by 15% and cognitive impairment by 16%. The large, cluster-randomized trial in rural China once again illuminated the role of "village doctors," the local term for community health workers, who outdid usual care. 

"This is an incredibly important study," Dan Jones, a past president of the American Heart Association, told STAT. He was not involved in the new research. "Here's something tangible that now we can tell our patients. This is so important for motivating people to control their blood pressure, and treating it intensively as well." 

The trial included nearly 34,000 people age 40 and older in rural China who had untreated hypertension. Just over half of the people received care from community health workers who started them on blood pressure medications, adjusting the drugs and the doses as needed to reach a goal of bringing blood pressure below 130/80 mm Hg. These non-physicians also gave participants discounted or free antihypertensive medications and coached them on home blood pressure monitoring, lifestyle changes (such as weight loss, reducing dietary sodium, and limiting alcohol), and medication adherence.

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Whole villages were in either the intervention group or the control group, whose members received usual care from their health care providers to reach a more modest target blood pressure of below 140/90 mm Hg. People who got more intensive guidance in the intervention villages took an average of three different blood pressure drugs, compared to one that people in the control villages were given.

After four years, the intervention group achieved better blood pressure control as well as a 15% reduction in dementia and a 16% reduction in cognitive impairment.

"Our study is the first to report a statistically significant reduction in the risk of all-cause dementia associated with antihypertensive treatment, providing strong evidence to support its use for the primary prevention of dementia," study author Jiang He, a physician and professor of epidemiology at UT Southwestern, told STAT in an email. 

The non-physician community health care providers have garnered attention before for their success at controlling blood pressure and reducing risk for cardiovascular disease. Well-trained but not M.D.S, they've helped thousands of people living with high blood pressure in rural regions, studies in the Lancet in 2022 and JAMA Cardiology in 2024 focused on cardiovascular risk have said.

Village doctors are seen as key players in places with lower income, Jones wrote in an editorial that appeared with the JAMA Cardiology paper.  

"This focus on low-resource settings would be a comprehensible recommendation if hypertension control rates were much better in high-resource settings, such as in the U.S. This is not the case. Might it be that this simple approach would be useful not only in low-resource settings but in high-resource settings as well?"

Nearly half of American adults have blood pressure higher than 130/80 mm Hg, three-quarters of whom do not have it under control, the Centers for Disease Control and Prevention says. Much like the village doctors in China, community health workers lowered blood pressure among certain populations in New York, this 2023 study demonstrated. But an effort  in Maryland and Pennsylvania had mixed results, a 2024 study reported. 

Next research steps might be longer studies in different populations with more frequent cognitive assessments, the paper's authors and outside experts suggested.

"It is encouraging that the intervention worked in real-world, rural settings using non-physician healthcare workers. However, this four-year study cannot tell us whether the benefits will last in the long-term,"  Richard Oakley, associate director of research and innovation at the U.K.'s Alzheimer's Society, said in a statement. "Although no single behaviour is guaranteed to prevent dementia, we know that what's good for your heart is often also good for your head."

The study's strength in establishing cause and effects helps solidify what's been advanced before as a correlation.

"It would take a lot of money, a lot of years, but I think if you take the results of this study and extrapolate to what it might mean for younger and middle-aged patients, the impact could really be astounding," Jones said. "But you have to do the studies to know that for sure."

STAT's coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.

A New Way Of Visualizing Blood Pressure Data Can Help Doctors Better Manage Patients With Hypertension

If a picture is worth a thousand words, how much is a graph worth? For doctors trying to determine whether a patient's blood pressure is within normal range, the answer may depend on the type of graph they're looking at.

A new study from the University of Missouri highlights how different graph formats can affect clinical decision-making. Because blood pressure fluctuates moment to moment, day to day, it can be tricky for doctors to accurately assess it.

"Sometimes a patient's blood pressure is high at the doctor's office but normal at home, a condition called white coat hypertension," Victoria Shaffer, a psychology professor in the College of Arts and Science and lead author of the study, said. "There are some estimates that 10% to 20% of the high blood pressure that gets diagnosed in the clinic is actually controlled -- it's just white coat hypertension -- and if you take those same people's blood pressure at home, it is really controlled."

In the study, Shaffer and the team showed 57 doctors how a hypothetical patient's blood pressure data would change over time using two different types of graphs. One raw graph showed the actual numbers, which displayed peaks and valleys, while the other graph was a new visual tool they created: a smoothed graph that averages out fluctuations in data.

When the blood pressure of the patient was under control but had a lot of fluctuation, the doctors were more likely to accurately assess the patient's health using the new smoothed graph compared to the raw graph.

"Raw data can be visually noisy and hard to interpret because it is easy to get distracted by outliers in the data," Shaffer said. "At the end of the day, patients and their doctors just want to know if blood pressure is under control, and this new smoothed graph can be an additional tool to make it easier and faster for busy doctors to accurately assess that."

This proof-of-concept study is the foundation for Shaffer's ongoing research with Richelle Koopman, a professor in the School of Medicine, which includes working with Vanderbilt University and Oregon Health & Science University to determine whether the new smoothed graph can one day be shown to patients taking their own blood pressure at home. The research team is working to get the technology integrated with HIPAA-compliant electronic health records that patients and their care team have access to.

This could alleviate pressure on the health care system by potentially reducing the need for in-person visits when blood pressure is under control, reducing the risk for false positives that may lead to over-treatment.

"There are some people who are being over-treated with unnecessary blood pressure medication that can make them dizzy and lower their heart rate," Shaffer said. "This is particularly risky for older adults who are more at risk for falling. Hopefully, this work can help identify those who are being over-treated."

The findings were not particularly surprising to Shaffer.

"As a psychologist, I know that, as humans, we have these biases that underlie a lot of our judgments and decisions," Shaffer said. "We tend to be visually drawn to extreme cases and perceive extreme cases as threats. It's hard to ignore, whether you're a patient or a provider. We are all humans."

Given the increasing popularity of health informatics and smart wearable devices that track vital signs, the smoothed graphs could one day be applied to interpreting other health metrics.

"We have access to all this data now like never before, but how do we make use of it in a meaningful way, so we are not constantly overwhelming people?" Shaffer said. "With better visualization tools, we can give people better context for their health information and help them take action when needed."

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