ESOC 2023 | Intensive blood pressure lowering to reduce risk of new subclinical brain infarcts

Kyle Kern, MD, National Institute of Neurological Disorders and Stroke (NINDS), Bethesda, MD, shares the results of a secondary analysis of SPRINT-MIND, in which the team investigated the relationship between subclinical brain infarcts (SBI) and intensive systolic blood pressure (BP) treatment. The SPRINT MIND trial, published in 2019, assessed the value of intensive BP control (less than 120mmHg) to reduce the occurrence of dementia, findings no significant reduction in risk over the ~5 year median follow-up period, compared to standard BP control. In this secondary analysis, the impact of intensive versus standard BP control to reduce the risk of SBI or clinical stroke was assessed. Baseline SBI increased the risk of new SBI, clinical stroke, and mild cognitive impairment. No association between BP intervention and new ischemic events was noted in the overall population of 667 participants. However, in those with baseline SBI (74 participants), intensive BP lowering reduced the risk of recurrent SBI and clinical stroke. There was no effect of treatment on MCI risk. This interview took place during the European Stroke Organisation Conference (ESOC) in Munich, Germany.

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