DT‐01‐03: A RANDOMIZED TRIAL OF INTENSIVE VERSUS STANDARD SYSTOLIC BLOOD PRESSURE CONTROL ON BRAIN STRUCTURE: RESULTS FROM SPRINT MIND MRI

increased cardiovascular risk but without diabetes.Methods:Participants in the Systolic Blood Pressure Intervention Trial (SPRINT, n 1⁄4 9,361) were randomized to a SBP target of <120 mmHg (intensive treatment) versus <140 mmHg (standard treatment). The primary outcome was incident probable dementia. Secondary outcomes included MCI and a composite outcome of MCI or probable dementia. Each outcome was adjudicated by an expert panel blinded to treatment group. Results: Recruitment began 10/20/ 2010. At one year, mean systolic blood pressure was 121.4 mmHg in the intensive-treatment group and 136.2 mmHg in the standard treatment group. Treatment was stopped on 8/20/2015 due to cardiovascular disease (CVD) benefit after a median follow up of 3.26 years, but cognitive assessment continued until 6/29/ 2018. Participant mean age was 67.9 years (35.6% women) and 8,626 (92.1%) completed at least one follow-up cognitive assessment. There was a significantly lower rate of adjudicated incident MCI (HR 1⁄4 0.83, 95% CI: 0.71 to 0.97, p1⁄40.02) and a non-significant reduction in probable dementia (HR 1⁄4 0.84, 95% CI: 0.67 to 1.05, p1⁄40.12). The combined outcome of MCI plus probable all cause dementia was significantly lower (HR 1⁄4 0.86, 95% CI: 0.75 to 0.99, p 1⁄4 0.03) in the intensive versus standard treatment group. Conclusions: Among ambulatory adults at increased risk for CVD but without diabetes, treating to a SBP target <120 mmHg compared to a target of <140 mmHg reduces the risk of MCI, the combination of MCI/probable dementia, but not probable dementia alone. Trial registration: clinicaltrials.gov. Identifier: NCT01206062.