Launched in 2010, the NIH-supported SPRINT effort initially enabled scientists to compare the effects of standard versus intensive blood pressure control on cardiovascular health and mortality. More than 9,300 adults who were at least 50 years old and had a high risk for cardiovascular disease received either standard treatment, which lowered systolic blood pressure, the first of two numbers measured during an exam, to less than 140 mm Hg (<140 mm Hg), or intensive treatment to lower the same pressure reading below 120 mm Hg (<120 mm Hg). In August 2015, NIH surprisingly ended the trial early after initial results showed that 3.3 years of intensive treatment significantly reduced the rates of death and cardiovascular disease.

The NIA and NINDS supported sub-study, SPRINT MIND, enabled scientists from 27 clinical sites to examine the effects these treatments had on the brain by measuring cognitive function and acquiring MRI scans on a subset of SPRINT participants. The researchers compared brain scans of 449 participants that were taken at enrollment and four years later. During this time, the average increase in total volume of white matter lesions on scans of the intensive treatment group was 0.92 cm3, which was less than the 1.45 cm3 seen on scans from the standard treatment participants.


“Intensive treatment significantly reduced white matter lesion accumulation in people who had a higher chance of experiencing this kind of damage because they had high blood pressure,” said Clinton B. Wright, M.S., M.D., director of the Division of Clinical Research at NINDS, and an author of the study.

The SPRINT MIND researchers also reported slightly more loss of brain volume in the intensive treated group than those in the standard treatment. The effect was seen predominantly in males. However, the authors noted this loss was generally very small and of unclear clinical significance.

“SPRINT MIND has produced promising initial results in the battle against the nation’s growing problem with aging brain disorders. Both the brain scans and the cognitive tests reinforce the potential benefits that intensive blood pressure management may have on the brain,” said Lenore J. Launer, Ph.D., a senior investigator in the NIA Laboratory of Epidemiology and Population Sciences and co-author of the paper. “We hope that these findings will become the foundation for future studies on how to protect the brain throughout a person’s life.”

In the future, SPRINT MIND researchers plan to look at how controlling blood pressure may affect the accumulation of white matter lesions in critical regions of the brain affected by aging brain disorders and what factors may make some people more responsive to treatment.

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