Cognitive Outcomes With BP Intervention

During a poster session at the National Kidney Foundation Spring Clinical Meetings 2023, Rohit Nalamati, MBBS, and colleagues at the University of Utah, Salt Lake City, presented results of a study testing the hypothesis that the effect of blood pressure on cognitive outcomes might be modified by baseline depressive symptoms. The poster was titled Influence of Baseline Depressive Symptoms on the Effect of BP Intervention on Cognitive Outcomes in the Systolic Blood Pressure Intervention Trial (SPRINT).

The researchers utilized data from SPRINT, a randomized controlled trial that examined the effects of a systolic blood pressure goal of <120 mmHg versus <140 mmHg on cardiovascular and cognitive outcomes. Based on results from the Patient Health Questionnaire-9 (PHQ-9), the cohort for the current analysis was stratified into three groups: (1) no depressive symptoms (score 0); (2) minimal/mild depressive symptoms (score 1-9); and (3) moderate/severe depressive symptoms (score 10-27). The analysis was designed to identify the interactions of baseline PHQ-9 groups and systolic blood pressure intervention on adjudicated cognitive outcomes of mild cognitive impairment (MCI) or probable dementia (PD).

The analysis included 8487 SPRINT participants. The three baseline PHQ-9 groups were 34.6% (score 0), 57.9% (score 1-9), and 7.3% (score 10-27). Overall, there were 1243 MCI events and 322 PD events. Blood pressure intervention lowered the risk of a composite of MCI/PD, while higher baseline PHQ-9 scores were associated with a higher risk of MCI/PD.

In conclusion, the researchers said, “Intensive systolic blood pressure control resulted in decreased hazard of developing MCI/PD and presence of baseline moderate/severe depressive symptoms was associated with significant increase in hazard of developing PD and PD/MCI. Nonetheless, there was no evidence that the effects of blood pressure intervention on cognitive outcomes were modified by baseline depressive symptoms.”

Source: Nalamati R, Cherukuri S, Hartsell S, et al. Influence of baseline depressive symptoms on the effect of BP intervention on cognitive outcomes in the Systolic Blood Pressure Intervention Trial (SPRINT). Poster #374. Abstract of a poster presented during the National Kidney Foundation Spring Clinical Meetings 2023; April 11-15, 2023; Austin, Texas.