• Priya Palta, Marilyn S Albert, and Rebecca F Gottesman.
• Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, New York, NY, USA. Electronic address: pp2464@cumc.columbia.edu.
• Lancet Neurol. 2021 Oct 1; 20 (10): 854-867.

AbstractThe enormous societal and financial burden of Alzheimer's disease and related dementias requires the identification of risk factors and pathways to reduce dementia risk. Blood pressure (BP) management and control is one promising area, in which data have been inconclusive. Accumulating evidence over the past 5 years shows the effectiveness of BP management interventions among older individuals at risk, most notably from the SPRINT-MIND trial. These findings have been coupled with longitudinal observational data. However, to date, the results do not concur on the optimal timing and target of BP lowering, and further study in diverse populations is needed. Given the long preclinical phase of dementia and data supporting the importance of BP control earlier in the lifecourse, long-term interventional and observational studies in ethnically and racially diverse populations, with novel imaging and blood-based biomarkers of neurodegeneration and vascular cognitive impairment to understand the pathophysiology, are needed to advance the field.Copyright © 2021 Elsevier Ltd. All rights reserved.

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