New research in JAMA Internal Medicine found that discontinuation of antihypertensive therapy in patients aged ≥75 with mild cognitive impairment did not lead to improvements in short-term cognitive, psychological, or general daily functioning.

Justine E. F. Moonen, MD, of Leiden University Medical Center, the Netherlands, and colleagues conducted a community-based randomized-controlled trial in patients aged ≥75 with mild cognitive defects and no serious cardiovascular disease who received antihypertensive treatment. Participants were randomized to continue using their antihypertensive medication (n=186) or discontinue (n=199) and were followed for 16 weeks on changes in an overall cognition compound score and changes in scores on cognitive domains, depression, apathy, functional status, and quality of life.

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Overall cognition compound scores did not differ among the two groups, nor did changes for cognitive domains (executive function, memory and psychomotor speed), symptoms of apathy and depression, functional status, and quality of life. Because the study focused on older patients without serious cardiovascular disease, the authors urge that future randomized clinical trials with longer follow-up can provide additional insight at to whether older persons with impaired cerebral autoregulation might benefit from less stringent BP [blood pressure] targets.

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