Well then your doctor will need to come up with something else.
http://www.medpagetoday.com/Cardiology/Prevention/59489?xid=nl_mpt_cardiodaily_2016-08-03&eun=g424561d0r
Intense management of blood pressure, cholesterol, and other vascular
risk factors had no significant impact on dementia, the open-label,
cluster-randomized controlled PreDIVA trial showed.
The dementia incidence over about 6 years came out similar for
patients who received intensive management and those on usual care (6.5%
and 7%), Edo Richard, MD, of Radboud University Medical Center in The Netherlands, and colleagues, reported at the Alzheimer's Association International Conference and simultaneously online in The Lancet.
"The
contrast between our groups was relatively small, probably because the
level of healthcare in The Netherlands is very good already, so it's
difficult to improve on an already high level of healthcare," Richard
said during an oral presentation at the meeting in Toronto. "Potentially
this intervention is more effective in countries with less developed
healthcare systems(Like the US) or in middle-income countries."
Cardiovascular risk factors are associated with an increased risk of
dementia, so Richard and colleagues decided to test whether an intensive
intervention targeting several of these risk factors can prevent
dementia in a general primary care population.
Overall, a total of 3,526 patients ages 70 to 78 at 26 healthcare
practices were randomized to either a nurse-led, multidomain
cardiovascular intervention or to usual care. The intervention targeted
blood pressure, smoking, exercise, overweight, cholesterol, and glucose
levels.
Patients were followed for a median of 6.7 years, and the primary
outcome was the development of dementia. Secondary outcomes included
stroke, MI, cognitive decline, dementia subtype, and mortality.
Richard said that many patients did end up dropping the intervention,
but since this was a pragmatic trial, his team made every effort to
follow up on all cases, and ultimately had outcomes for 98% of the
population.
"The
importance of a pragmatic outcome in a pragmatic trial in older people
is that it hugely facilitates the interpretation of the results,"
Richard said.
Overall, they saw no difference in the primary endpoint, with 7% of
those in the standard care developing dementia compared with 6.5% of
those in the intensive vascular intervention group (hazard ratio 0.92,
95% CI 0.71 to 1.19).
They did see a mean 2 mm Hg reduction in blood pressure for those in
the intervention, which is "very modest, but on a population level this
could be relevant," Richard said, adding that those with the highest
blood pressure at baseline garnered the most benefit.
There was no treatment effect on any of the other vascular risk factors.
In sensitivity analyses, there was a trend toward a benefit for the
intervention in the per-protocol analysis, but it was of borderline
significance (HR 0.78, 95% CI 0.58 to 1.04).
For
the secondary outcome of dementia subtype, they saw a reduction in the
risk of non-Alzheimer's dementia (HR 0.37, 95% CI 0.18 to 0.76) but this
was based on a small number of cases, Richard warned.
There was also a trend toward a benefit of the intervention for those
with untreated hypertension, and when they looked specifically at
untreated patients who remained adherent, there was a significant
reduction in dementia risk (HR 0.54, 95% CI 0.32 to 0.92) -- but again
Richard noted that this was based on a small number of cases.
He concluded that their work shows that intensive vascular care in
older patients "is safe. People were afraid it would be dangerous but we
did not see any excess mortality or any excess hospitalizations in the
intervention group compared with the control group."
"There was no significant effect on all-cause dementia, but we did
see some interesting signals in the direction of a potential effect in
adherent patients and in those with untreated hypertension, which could
be used to guide development of future trials to prevent dementia," he
said. "And it suggests an effect on non-Alzheimer's dementia, but we
must interpret this with care."
Maria Carrillo, PhD,
chief science officer of the Alzheimer's Association, said that despite
the fact the study was negative on its primary outcome, its additional
findings "suggest once again the benefits – for the head and the heart –
of assessing, treating and managing heart health risk factors as we
age."
The study was supported by the Dutch Ministry of Health.
Use the labels in the right column to find what you want. Or you can go thru them one by one, there are only 29,120 posts. Searching is done in the search box in upper left corner. I blog on anything to do with stroke.DO NOT DO ANYTHING SUGGESTED HERE AS I AM NOT MEDICALLY TRAINED, YOUR DOCTOR IS, LISTEN TO THEM. BUT I BET THEY DON'T KNOW HOW TO GET YOU 100% RECOVERED. I DON'T EITHER, BUT HAVE PLENTY OF QUESTIONS FOR YOUR DOCTOR TO ANSWER.
Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.
What this blog is for:
My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.
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