A large study conducted in rural China suggests that intensive treatment of high blood pressure could help reduce the risk of dementia, providing new evidence that controlling a common cardiovascular risk factor may also protect long-term brain health. Researchers found that adults who received structured, community-based blood pressure management had a 15 percent lower risk of developing dementia over seven years compared with those who received standard care. The findings, presented in a Hot Line session at the ESC Congress 2026, come as dementia rates are projected to rise dramatically worldwide, from 57 million people in 2019 to 153 million by 2050.
Known as the China Rural Hypertension Control Program (CRHCP), the study was led by researchers Professor Yingxian Sun and Dr. Shanshan Zhong from The First Affiliated Hospital of China Medical University, Shenyang, China. It included 33,995 adults from 326 rural villages across China.
Participants were aged 40 and older, with an average age of 63, and 61 percent were women. All had elevated blood pressure that met the study's eligibility criteria. Investigators compared two different approaches to blood pressure management.
One group received usual care, while the intervention group participated in an intensive treatment program delivered by trained community healthcare providers who were not physicians. These providers worked under the supervision of primary care doctors and followed a structured treatment plan that included starting medications when necessary and adjusting them over time. The goal was to help participants reach blood pressure targets below 130 mmHg systolic and below 80 mmHg diastolic.
The program involved four years of active treatment followed by an additional three years of observation, for a total follow-up period of seven years. By the end of the study, participants in the intensive-treatment group achieved substantially larger reductions in blood pressure. Systolic blood pressure fell by 17.6 mmHg on average among those receiving the intervention, compared with a reduction of just 2.4 mmHg in the usual-care group.
Researchers also found significant differences in cognitive outcomes. After seven years, dementia developed in 8.85 percent of participants in the intervention group, compared with 10.55 percent in the usual-care group, representing a 15 percent lower risk among those receiving intensive blood pressure treatment. The benefits extended beyond dementia diagnoses alone.
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