Antihypertensive regimens that perhaps work a little too well were linked to faster cognitive decline among older adults with pre-existing dementia or mild cognitive impairment (MCI) in a cohort study.

Patients in the lowest tertile of daytime systolic blood pressure (128 mmHg or less) showed a greater decline in Mini-Mental State Examination (MMSE) score over a median 9 months than those in the middle tertile (129 to 144 mmHg) or those in the top tertile of 145 mmHg or higher — mean -2.8 points on the 30-point MMSE scale versus -0.7 in both higher groups (P=0.002 and P=0.003, respectively).

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