The abstract is read at the publisher; the summary is JClub's.
Intensive systolic blood pressure control to <120 mm Hg versus <140 mm Hg in adults with type 2 diabetes showed no statistically significant difference in all-cause dementia or mild cognitive impairment over a median 3.8 years (HR 0.96, P=0.38).
- Why it matters: It addresses whether tighter blood pressure targets in type 2 diabetes improve cognitive outcomes and brain structure, despite uncertainty about links between vascular risk management and neurodegeneration.
- What they did: In a multicentre open-label randomized trial in China (12,434 without probable dementia; MRI subset 862 to 605), participants received intensive or standard SBP targets for up to five years, with annual cognitive assessments and MRI measures of white matter lesion volume and total brain volume.
- The result: The composite cognitive outcome occurred in 747 vs 783 participants (3.69 vs 3.89 events per 100 person-years; HR 0.96, 95% CI 0.86–1.06). In the MRI substudy, intensive treatment reduced white matter lesion volume increase versus standard (between-group difference −0.09 asinh-transformed cm³, 95% CI −0.15 to −0.02; P=0.01).
The findingWhy it mattersWhat they didThe result
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