Trial reportNature medicine2025
Blood pressure reduction and all-cause dementia in people with uncontrolled hypertension: an open-label, blinded-endpoint, cluster-randomized trial.
Trial report in Nature medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03527719 (Effectiveness of a Standardized Protocol-based Treatment Program on Hypertension Control in Rural China), which is not on this map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effectiveness of a Standardized Protocol-based Treatment Program on Hypertension Control in Rural China
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Guideline
- Management of brain-heart multimorbidity: a clinical practice guideline.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Guideline
- Cardiovascular-kidney-metabolic syndrome stage modifies the efficacy of intensive blood pressure control on cognitive outcomes: A post hoc analysis of SPRINT MIND.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Trial
- Intensive BP Control and Cognitive Function: A Randomized Clinical Trial.Hypertension (Dallas, Tex. : 1979) · 2026Trial
- The path to treating multiple-etiology dementia: Combining vascular risk control and disease-modifying neurodegenerative therapies.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Review
- The 2025 AHA/ACC Hypertension Guidelines: Key Updates, Historical Context, and Clinical Implications.Current cardiology reports · 2026Review
- Digitally enabled GP-specialist collaborative care helped improve hypertension outcomes and reduced hospital referrals in China.npj health systems · 2026Article
- Intensive blood pressure control is beneficial for preventing stroke in patients with dementia.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Hypertension acts together with Aβ pathology in late-life to promote memory loss.The journal of prevention of Alzheimer's disease · 2026Article
- Natriuretic Peptides as a Biomarker of Cognitive Decline in Hypertension.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026Review
- Plasma p-tau markers, vascular factors, and cognitive decline in the CIMA-Q cohort.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Sarcopenia in cognitive disorders: Toward a shared pathophysiological framework.Osteoporosis and sarcopenia · 2026Review
- Development and validation of a Cog-Free risk predicting tool for dementia in a community setting.General psychiatry · 2026Article
- Epidemiological and clinical evidence on blood pressure management for the prevention of dementia: striving for a healthy 100-year life.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- The principles of Population-Level Approaches to Dementia Risk Reduction (PLADRR).PLoS medicine · 2026Article
- Dietary Patterns and Indicators of Cognitive Function.JAMA neurology · 2026Article
- Longitudinal blood pressure trajectories and tau-lipid biomarkers associated with dementia in hypertensive adults: Results from the population-based CRHCP cohort.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Hypertensive Brain Injury as a Journey Not a Destination.Journal of the American Heart Association · 2026Article
- Updates in the 2025 AHA/ACC Hypertension Guideline.Current hypertension reports · 2026Review
- Class-Specific Antihypertensives and Alzheimer's Disease: Genotype- and Hypertension-Stratified Analysis.Molecular neurobiology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
Abstract
Dementia is a leading cause of death and disability worldwide. Here we tested the effectiveness of blood pressure (BP) reduction on the risk of all-cause dementia among 33,995 individuals aged ≥40 years with uncontrolled hypertension in rural China. We randomly assigned 163 villages to a non-physician community healthcare provider-led intervention and 163 villages to usual care. In the intervention group, trained non-physician community healthcare providers initiated and titrated antihypertensive medications according to a simple stepped-care protocol to achieve a systolic BP goal of <130 mm Hg and a diastolic BP goal of <80 mm Hg, with supervision from primary care physicians. Over 48 months, the net reduction in systolic BP was 22.0 mm Hg (95% confidence interval (CI) 20.6 to 23.4; P < 0.0001) and that in diastolic BP was 9.3 mm Hg (95% CI 8.7 to 10.0; P < 0.0001) in the intervention group compared to usual care. The primary outcome of all-cause dementia was significantly lower in the intervention group than in the usual care group (risk ratio: 0.85; 95% CI 0.76 to 0.95; P = 0.0035). Additionally, serious adverse events occurred less frequently in the intervention group (risk ratio: 0.94; 95% CI 0.91 to 0.98; P = 0.0006). This cluster-randomized trial indicates that intensive BP reduction is effective in lowering the risk of all-cause dementia in patients with hypertension. ClinicalTrials.gov: NCT03527719 .
Indexed as
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.