The enormous societal and financial burden of Alzheimer's disease and related dementias requires the identification of risk factors and pathways to reduce dementia risk. Blood pressure (BP) management and control is one promising area, in which data have been inconclusive. Accumulating evidence over the past 5 years shows the effectiveness of BP management interventions among older individuals at risk, most notably from the SPRINT-MIND trial. These findings have been coupled with longitudinal observational data. However, to date, the results do not concur on the optimal timing and target of BP lowering, and further study in diverse populations is needed. Given the long preclinical phase of dementia and data supporting the importance of BP control earlier in the lifecourse, long-term interventional and observational studies in ethnically and racially diverse populations, with novel imaging and blood-based biomarkers of neurodegeneration and vascular cognitive impairment to understand the pathophysiology, are needed to advance the field.

阿尔茨海默病和相关痴呆症的巨大社会和经济负担需要确定风险因素和途径以降低痴呆症风险。血压 (BP) 管理和控制是一个很有前景的领域，但其中的数据尚无定论。过去 5 年积累的证据表明，血压管理干预对处于风险的老年人中的有效性，尤其是来自 SPRINT-MIND 试验的证据。这些发现与纵向观测数据相结合。然而，迄今为止，结果并未就降压的最佳时机和目标达成一致，需要在不同人群中进一步研究。鉴于痴呆症的长期临床前阶段和支持生命过程早期血压控制重要性的数据，