Evidence map›Paper›PMID 40258956›Full record

Trial reportNature medicine2025

Blood pressure reduction and all-cause dementia in people with uncontrolled hypertension: an open-label, blinded-endpoint, cluster-randomized trial.

Jiang He, Chuansheng Zhao, Shanshan Zhong, Nanxiang Ouyang, Guozhe Sun, Lixia Qiao, Ruihai Yang, Chunxia Zhao, Huayan Liu, Weiyu Teng and 6 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Nature medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03527719 (Effectiveness of a Standardized Protocol-based Treatment Program on Hypertension Control in Rural China), which is not on this map. Cited by 27 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03527719 naactive not recruitingnot on this map

Effectiveness of a Standardized Protocol-based Treatment Program on Hypertension Control in Rural China

TypeinterventionalSponsorFirst Hospital of China Medical UniversityRan2018 to 2026Enrolled33,995ConditionsHypertensionArmsVillage-doctor-led multifaceted intervention
3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026
    Guideline
  2. Management of brain-heart multimorbidity: a clinical practice guideline.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026
    Guideline
  3. Trial
  4. Trial
  5. Hypertension acts together with Aβ pathology in late-life to promote memory loss.The journal of prevention of Alzheimer's disease · 2026
    Article
  6. Intensive blood pressure control is beneficial for preventing stroke in patients with dementia.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  7. Natriuretic Peptides as a Biomarker of Cognitive Decline in Hypertension.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026
    Review
  8. Plasma p-tau markers, vascular factors, and cognitive decline in the CIMA-Q cohort.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Article
  9. Review
  10. Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. Hypertensive Brain Injury as a Journey Not a Destination.Journal of the American Heart Association · 2026
    Article
  16. Updates in the 2025 AHA/ACC Hypertension Guideline.Current hypertension reports · 2026
    Review
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Jiang He *Department of Epidemiology, Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, TX, USA. jiang.he@utsouthwestern.edu.ORCID http://orcid.org/0000-0002-8286-9652
Chuansheng Zhao *Department of Neurology, First Hospital of China Medical University, Shenyang, China.
Shanshan Zhong *Department of Neurology, First Hospital of China Medical University, Shenyang, China.
Nanxiang Ouyang *Department of Cardiology, First Hospital of China Medical University, Shenyang, China.
Guozhe Sun *Department of Cardiology, First Hospital of China Medical University, Shenyang, China.
Lixia Qiao *Department of Cardiology, First Hospital of China Medical University, Shenyang, China.
Ruihai YangHanzhong People's Hospital, Hanzhong, China.
Chunxia ZhaoDivision of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
Huayan LiuDepartment of Neurology, First Hospital of China Medical University, Shenyang, China.
Weiyu TengDepartment of Neurology, First Hospital of China Medical University, Shenyang, China.
Xu LiuDepartment of Neurology, First Hospital of China Medical University, Shenyang, China.
Chang WangDepartment of Cardiology, First Hospital of China Medical University, Shenyang, China.
Songyue LiuDepartment of Cardiology, First Hospital of China Medical University, Shenyang, China.
Chung-Shiuan ChenTulane University Translational Science Institute, New Orleans, LA, USA.
Jeff D WilliamsonSticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine, Section on Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Yingxian SunDepartment of Cardiology, First Hospital of China Medical University, Shenyang, China. yxsun@cmu.edu.cn.ORCID http://orcid.org/0000-0002-1961-899X

Funding

Ministry of Science and Technology of the People's Republic of China (Chinese Ministry of Science and Technology) 2017YFC1307600
6 · The paper itself

Abstract

Dementia is a leading cause of death and disability worldwide. Here we tested the effectiveness of blood pressure (BP) reduction on the risk of all-cause dementia among 33,995 individuals aged ≥40 years with uncontrolled hypertension in rural China. We randomly assigned 163 villages to a non-physician community healthcare provider-led intervention and 163 villages to usual care. In the intervention group, trained non-physician community healthcare providers initiated and titrated antihypertensive medications according to a simple stepped-care protocol to achieve a systolic BP goal of <130 mm Hg and a diastolic BP goal of <80 mm Hg, with supervision from primary care physicians. Over 48 months, the net reduction in systolic BP was 22.0 mm Hg (95% confidence interval (CI) 20.6 to 23.4; P < 0.0001) and that in diastolic BP was 9.3 mm Hg (95% CI 8.7 to 10.0; P < 0.0001) in the intervention group compared to usual care. The primary outcome of all-cause dementia was significantly lower in the intervention group than in the usual care group (risk ratio: 0.85; 95% CI 0.76 to 0.95; P = 0.0035). Additionally, serious adverse events occurred less frequently in the intervention group (risk ratio: 0.94; 95% CI 0.91 to 0.98; P = 0.0006). This cluster-randomized trial indicates that intensive BP reduction is effective in lowering the risk of all-cause dementia in patients with hypertension. ClinicalTrials.gov: NCT03527719 .

Indexed as

Antihypertensive AgentsBlood PressureDementiaHypertensionAdultAgedChinaFemaleHumansMaleMiddle AgedAntihypertensive Agents

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.