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Although intensive blood pressure (BP) lowering may have cognitive benefits regardless of baseline OH status, its effects in participants who develop OH during intervention remain unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants of the Systolic Blood Pressure Intervention Trial (SPRINT) were randomised to either intensive treatment (systolic BP target &amp;lt;120\u00a0mmHg) or standard treatment (systolic BP target &amp;lt;140\u00a0mmHg). This post hoc analysis defined new-onset OH as a systolic BP reduction \u226520\u00a0mmHg and\/or a diastolic BP reduction \u226510\u00a0mmHg from a seated to a standing position at any follow-up visit during intervention. The primary outcome was probable dementia. Other outcomes included mild cognitive impairment (MCI), and a composite of probable dementia or MCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Amongst 7911 participants without OH at baseline (representing 84.5% of randomised participants in SPRINT; mean age, 67.7\u00a0years; 34.7% women), 1264 (16.0%) developed new-onset OH during intervention. Intensive treatment was associated with a lower risk of probable dementia (HR, 0.76; 95% CI, 0.58 to 0.98) amongst participants without new-onset OH, but with a higher risk (HR, 2.39; 95% CI, 1.33 to 4.32) amongst participants with new-onset OH. No significant association was observed between intensive treatment and MCI, or the composite outcome in participants with new-onset OH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The occurrence of OH requires close monitoring, with caution for potential cognitive adverse effects during ongoing intensive BP-lowering treatment. Validation of current findings in studies with justified methodological designs is warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p>URL: ClinicalTrials.gov; Unique Identifier: NCT01206062.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ageing\/afag005","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T12:31:54Z","timestamp":1768307514000},"source":"Crossref","is-referenced-by-count":2,"title":["Intensive blood pressure control and risks of cognitive outcomes in patients with new-onset orthostatic hypotension"],"prefix":"10.1093","volume":"55","author":[{"given":"Siyu","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025 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