Changes in arterial stiffness under blood pressure control are independently associated with cognitive impairment: The Systolic Blood Pressure Intervention Trial (SPRINT).

<h4>Background</h4>Effects of blood pressure (BP) control on the relationships between arterial stiffness and subsequent cognitive impairment remain unclear.<h4>Methods</h4>The Systolic Blood Pressure Intervention Trial Pulse Wave Velocity (PWV) substudy evaluated the effect BP control on total (T-PWV, in m/s), structural (S-PWV), and load-dependent (LD-PWV) arterial stiffness over 3 years as they related to time to cognitive impairment over 10 years modeled using multivariable proportional hazard models for baseline stiffness and joint longitudinal survival models for changes in stiffness.<h4>Results</h4>Six hundred fourteen participants with stiffness measures had 90 cognitive impairment events over follow-up. Reductions in LD-PWV under intensive BP control were associated with 21% risk reduction for cognitive impairment. T-PWV and S-PWV continued to increase regardless of BP control with each m/s increase in stiffness associated with 11% to 12% increase in risk for cognitive impairment.<h4>Discussion</h4>Intensive SBP control reduced LD-PWV over 3 years, which reduced the risk of cognitive impairment over 10 years of follow-up.