This large trial of over 33,000 people in rural China provides further evidence that addressing high blood pressure could be one way to reduce dementia risk. This is consistent with a landmark report published in The Lancet last year, which highlighted untreated high blood pressure as one of 14 risk factors that account for almost half of global dementia cases. Existing medicines and lifestyle changes to reduce blood pressure could present a more accessible way to lower dementia risk for those with high blood pressure.

While the results from this trial are reassuring, further studies are needed to understand how other risk factors like genetics interact with factors like high blood pressure to influence dementia risk. It will also be interesting to see whether interventions trialed in this study can work in other populations across the world. 

Looking after our heart and blood vessel health is something we can all do to improve our overall wellbeing and reduce our risk of dementia. With no current treatments available on the NHS to slow or stop the diseases that cause dementia, there has never been a more pressing need to promote good brain health and to gain a deeper understanding of how we can reduce our risk of developing dementia.

The government also has a vital role to play in tackling the health and lifestyle factors that influence dementia risk – including cardiovascular health. This could mean introducing policies to reduce salt, sugar, and calories in processed foods, and lowering the NHS Health Check eligibility age in England from 40 to 30, so more people can start managing their blood pressure earlier in life.

If you’re worried about your blood pressure, or haven’t had it checked for a while, speak to your GP or your local pharmacy may offer this service. If you’re over 40, you should ideally have your blood pressure checked at least every five years.

There has been evidence for a long time that people who have high blood pressure have a higher risk of developing dementia, especially vascular dementia. The findings of this large trial, involving high blood pressure treatments that are already widespread, offer strong evidence that enhanced treatment of high blood pressure could in turn reduce the heightened dementia risk that comes with it.

It will be important to see whether this reduced risk continues for longer than the four-year follow up period in the study, and whether similar effects are seen in other populations that receive the same treatment. If so, wider use of high blood pressure treatment in people with the condition could be recommended to fight the growing impact of dementia.

This is a landmark study with a very large sample size and a robust effect. It’s a wake-up call to treat high blood pressure intensively, not just to protect the heart but also the brain.

Remarkably, within just four years, there was a significant reduction in the incidence of dementia by aggressively treating raised blood pressure. Although many patients and their GPs understand how important it is to treat blood pressure, they might not appreciate what a risk it poses for developing dementia. In my clinic, I recommend keeping BP consistently below 140/80.