Does Intensive Blood Pressure Lowering Prevent Dementia? A Podcast with Jeff Williamson
episode
GeriPal - A Geriatrics and Palliative Medicine Podcast
34 min
4 speakers
8 chapters
transcribed 5 hours ago
Transcript
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Transcript generated automatically by AI and may contain errors.
What contradictory headlines emerged from the recent JAMA study on intensive blood pressure lowering?
Welcome to the Jerry Pal podcast. This is Eric Widera.
This is Alex Smith. And Alex, I see somebody in the room with us. We have a guest host today with us. We have Lauren Hunt, who is a nurse postdoctoral fellow here at UCSF and presented the article we're going to discuss today at Journal Club a couple weeks ago. Welcome to Jerry Pal podcast, Lauren.
Thanks for having me. Hi, everybody.
And we have the lead author of the article I heard online. Is that right, Alex?
That's right. We have the lead author. This is a paper in JAMA, Effective Intensive vs. Standard Blood Pressure Control on Probable Dementia, a Randomized Clinical Trial. This is a hot topic. We have Jeff Williamson, who's the lead author, who's chief of geriatrics at Wake Forest, a great place. We know many people there. We were talking to Bill Applegate just yesterday. Welcome to the GeriPel podcast, Jeff.
Thank you. Thank you for having me. I've been looking forward to this.
I'm super excited to talk about this. I'm just looking at two different news headlines on this article, one saying intensive blood pressure treatment does not reduce blood dementia risk, and another one saying it slashes dementia risk. So I'm excited to hear which of those two news articles should I believe. But before we go in the article, Jeff, we always start off with a song recommendation for Alex. Do you have a song for him?
Yes, I lately have been thinking about the song Old Blue Chair. It's a Kenny Chesney song, so I'm not sure how familiar your audience would be with it, but it reminds me of where I want to be. That's nice.
Okay, Alex, let's give it a try.
There's a blue rocking chair Sitting in the sand weathered by the storms and our well-oiled hands it sways back and forth with the help of the winds it seems to always be there like an old trusted friend I've read a lot of books I wrote a few songs looked at my life where it's gone where it's gone seen the world through a bus windshield but nothing Do the way that I see it. Do the way that I see it. Do the way that I see it when I sit in my old blue chair.
That was awesome.
Nicely done,
Alex.
Thank you. Very good. Wow. That was fun to learn. Thank you very much for that.
I
can't wait
to download that.
Any particular reason you chose that song besides wanting to sit in that blue chair?
Yeah, I just I think I have a chair like that. I have a few chairs like that. And I just love to think about even the topic we're going to talk about today. And that's a really relaxing place for me. So that's why I chose
it. Great. So we're going to be talking about the Sprint Mind Trial. So the JAMA article that came out, Effective Intensive vs. Standard Blood Pressure Control on Probable Dementia. But usually before we go deep into the article, I'd love to hear just how did you get interested in this as a subject?
How was the SPRINT trial designed and what were the blood‑pressure targets?
Has this been something that you've been... has been an academic lifelong thing that you've been interested in?
Well, I've been very interested for many years in the need to include older adults and the outcomes in clinical trials that are important to older adults, like cognition, like physical function, in clinical trials, in tests of therapy. So often outcomes are disease-based, like stroke or myocardial infarction or mortality, and those are important outcomes, but Sprint, and we have other Sprint articles that actually incorporate what are important to us as geriatricians and more importantly to our patients. That is, how is this going to affect my physical and cognitive function if I do this? So that's really one of the main reasons that we've started on this journey.
So that brings me to actually one of the issues that came up when you were reading this in Journal Club. which was the issue of generalizability. Because we were struck that actually you guys had excluded people who lived in nursing homes and people with diabetes and people who had a history of stroke. And so then we were wondering if those of us who work in geriatrics would have any patients left after excluding all those people. Tough
questions right up
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Chapters
8 chapters
1
What contradictory headlines emerged from the recent JAMA study on intensive blood pressure lowering?
0:01–3:23
2
How was the SPRINT trial designed and what were the blood‑pressure targets?
3:23–7:00
3
Are the SPRINT results generalizable to typical geriatric patients, such as those in nursing homes or with diabetes?
7:00–11:48
4
Why does blood‑pressure measurement methodology matter when applying SPRINT findings to real‑world practice?
11:48–15:27
5
What were the main cognitive outcomes—mild cognitive impairment and dementia—reported in the trial?
15:27–20:48
6
Why didn’t the trial show a statistically significant reduction in dementia despite a trend?
20:48–24:48
7
How have the study findings changed the way clinicians manage blood pressure in older adults?
24:48–29:43
8
What future research or trial designs are needed to better assess blood‑pressure control on cognition and function?
29:43–34:43
Speakers
4 identifiedMore from GeriPal - A Geriatrics and Palliative Medicine Podcast
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