How to do it
- Get it measured at your doctor's. Write the top number down.
- If it's high, ask your doctor what your target should be, and why.
- Never change, stop or add blood pressure medicine on your own. In the trial, doctors managed treatment.
- Already treated? Ask at your next check whether your target is still right for you.
What happens next
- Your numberget it measured
The trial worked on the top number, systolic, the pressure as the heart beats.
- Targetset with a doctor
The trial compared aiming under 120 with aiming under 140, in adults 50 and over with high blood pressure.
- Treatmentmanaged to target
Doctors in the trial ran each group's treatment to its target. Changing medicine is theirs to do, not yours.
- Youless mild decline
Fewer people on the lower target developed mild memory and thinking trouble. Dementia itself wasn't clearly lower.
Why it works
A large trial took 9,361 adults aged 50 and over with high blood pressure and aimed their top number either under 120 or under 140. Over about five years, the lower target went with 19% less mild cognitive impairment, memory and thinking trouble that's noticeable but short of dementia. Evidence: decent Dementia was lower too, but not by enough to rule out chance. Evidence: decent
Knowing your number is the first step. The target is a conversation with your doctor.
The long readEvery step of the chain, each study with its numbers, and what's still unproven. 2 min read.
What happens next
This chain is a route to care, not brain areas.
Get the number. Blood pressure is read as two numbers. The trial targeted the top one, systolic, the pressure as the heart beats. Evidence: decent
A target, set with a doctor. The trial compared aiming under 120 with aiming under 140, in adults 50 and over with high blood pressure and no diabetes or past stroke. Evidence: decent
Treatment, managed. Each group was treated to reach its target by the trial's doctors. Evidence: decent
You: less mild decline. Fewer people on the lower target developed mild cognitive impairment. Evidence: decent Probable dementia wasn't clearly lower. Evidence: decent
The proof
- In 9,361 adults aged 50 and over with high blood pressure, aiming under 120 instead of under 140 went with 19% less mild cognitive impairment (hazard ratio 0.81, range 0.69 to 0.95). Treatment lasted a median of 3.3 years; follow-up, 5.1. Evidence: decent
- Probable dementia was 17% lower on the lower target, but the range ran from 33% lower to 4% higher, so it could be no effect at all (hazard ratio 0.83, range 0.67 to 1.04). Evidence: decent
- The trial was stopped early because the lower target cut heart problems and deaths. Evidence: decent The authors say that, with fewer dementia cases than expected, it may have been too small to settle dementia. Evidence: decent
How to do it
- Get your blood pressure measured and write the top number down.
- If it's high, ask your doctor what your target should be.
- Never change, stop or add blood pressure medicine on your own.
Watch out
This is not a reason to change your medication. The target is set with your doctor. The trial didn't include people with diabetes or a past stroke. Evidence: decent It cut mild cognitive impairment, not clearly dementia, and it stopped early. Evidence: decent
The lower target isn't free. In the main trial report, serious side effects were more common on it: low blood pressure (2.4% against 1.4%), fainting (2.3% against 1.7%), problems with the body's salt balance (3.1% against 2.3%) and sudden kidney injury (4.1% against 2.5%). Evidence: solid Falls causing injury weren't more common. Evidence: solid That trade-off is exactly what your doctor weighs when setting your target.