The Prevention of Dementia With Antihypertensive TreatmentNew Evidence From the Systolic Hypertension in Europe (Syst-Eur) Study

Abstract

HYPERTENSION IS associated with increased risk of both vascular dementia and Alzheimer disease.^1,2 In view of the increasing longevity of populations worldwide, prevention of dementia has turned into a major public health challenge.³ In the patients randomized in the double-blind Systolic Hypertension in Europe (Syst-Eur) trial, we observed that antihypertensive therapy, compared with placebo, reduced the incidence of dementia by 50%, from 7.7 to 3.8 cases per 1000 patient-years (21 vs 11 cases, P = .05).⁴ However, Collins and MacMahon⁵ suggested that our estimates of benefit were of limited value, largely because the number of incident cases in the two treatment groups combined was only 32.