Lower blood pressure target linked to slower progression of small vessel disease on brain scans

ScienceAlert reports that researchers compared brain scans from 442 SPRINT participants with high blood pressure, taken a median of 3.9 years apart. Targeting systolic pressure below 120 mmHg rather than below 140 was associated with less progression of a score combining three MRI signs of small vessel disease. The difference amounted to 16.9% of average disease burden at baseline. Larger actual blood pressure drops were also linked to slower progression, but that comparison was observational and cannot establish causation. This analysis was not planned in the original trial and did not establish fewer strokes or less cognitive decline. The findings also do not mean existing brain injury was reversed. Many participants lacked usable follow-up scans; whether the results apply to excluded groups, including people with diabetes or prior stroke, remains uncertain.