In rural China, community health workers ran a blood pressure program whose target sat below 130/80 mmHg. Over seven years dementia was recorded in 8.85 per cent of that arm and 10.55 per cent under usual care, and milder cognitive loss was 13 per cent lower. An Oxford analysis found every 5 mmHg systolic fall went with about 10 per cent fewer cardiovascular events at every risk level, while people treated to prevent one event ran from 38 to 255.
Dementia was recorded in 8.85 per cent of the village-led arm and 10.55 per cent under usual care over seven years in rural China. Cognitive impairment short of dementia was 13 per cent lower. Serious adverse events ran close in the two arms, at 47.15 per cent and 49.78 per cent. The figures put a late brain cost on a condition most clinics already treat as a heart problem.[1]
Non-physician community health providers ran the village program with a target below 130/80 mmHg. Four years of intensive control were followed by three years of observation. Systolic pressure fell by 17.6 mmHg in the village-led arm and by 2.4 mmHg under usual care. Mean age was 63.0 and 61 per cent of participants were women.[1]
Every 5 mmHg fall in systolic pressure went with roughly 10 per cent fewer cardiovascular events in relative terms at every risk level. Absolute gain diverged: a 2.6-point reduction in the highest-risk group against 0.4 points in the lowest-risk group. Palpitations and low blood pressure rose by 66 per cent and kidney problems by 49 per cent. The Oxford team argues for selecting patients by total cardiovascular risk rather than by a blood pressure threshold alone.[2]
