Intensive Blood Pressure Control Cuts Dementia Risk Over 7 Years

A community-based intensive blood pressure intervention reduced the 7-year incidence of dementia compared with usual care in the China Rural Hypertension Control Program (CRHCP), according to results presented during a Hot Line session at ESC Congress 2026 and reported by the European Society of Cardiology.

The cluster-randomized trial assigned 326 rural Chinese villages 1:1 to an intervention led by trained nonphysician community healthcare providers or to usual care. Under the supervision of primary care physicians, the providers used a simple stepped-care protocol to initiate and titrate antihypertensive medications toward a systolic blood pressure below 130 mm Hg and a diastolic blood pressure below 80 mm Hg.

The study enrolled 33,995 adults with hypertension. Mean age was 63 years, and 61% were women. The active intervention continued for 4 years, followed by 3 years of observation. At 7 years, systolic blood pressure had declined by 17.6 mm Hg from baseline in intervention communities and by 2.4 mm Hg with usual care.

Dementia occurred in 8.85% of participants in the intervention group and 10.55% in the usual-care group. This corresponded to a 15% lower adjusted risk with the intervention (risk ratio, 0.85; 95% CI, 0.78-0.91; P<.001). The risk of cognitive impairment without dementia was also 13% lower with the intervention. Serious adverse events were reported in 47.15% and 49.78% of participants, respectively.

Professor Yingxian Sun, principal investigator of the CRHCP, said the findings support the long-term integration of structured blood pressure management into routine primary care for population-level dementia prevention. The ESC described the nonphysician provider-led intervention as scalable.

Source: European Society of Cardiology. Long-term intensive blood-pressure control reduces dementia risk. Press release. European Society of Cardiology; August 30, 2026. Accessed September 1, 2026.