Whelton et al 2017 High Blood Pressure Clinical Practice Guideline e69 demonstrated a reduction in dementia incidence, with 2 of these 4 demonstrating statistical significance (746-751). SYST-EUR (Systolic Hypertension in and PROGRESS (Perindopril Protection Against Recurrent Stroke)S11.3-18 both showed statis- tically significant reductions in incident dementia. SYST-EUR achieved an SBP of 152 mm Hg in the treatment arm (8.3 mm Hg lower than placebo arm) during its blinded phase and an SBP of 149 mm Hg (7.0 mm Hg lower than comparison group) during its open-label follow-up phase.S11.3-2,S11.3-3 PROGRESS achieved an SBP of 138 mm Hg in the treatment group (9 mm Hg lower than the placebo group) and demon- strated dementia prevention in patients with a recent The trial showing no benefit in the direc- tion of dementia reduction achieved an SBP reduction of only 3.2 mm Hg, whereas the other 4 trials achieved SBP reductions of 7 to 15 mm Hg (746-751). When the rate of cognitive decline (not dementia) has been a trial outcome, 7 clinical trials of BP-lowering ther- apy have been completed, and 2 of these have shown No randomized trial of BP lowering has demonstrated an adverse impact on dementia incidence or cognitive function. However, the anticipated results from SPRINT, the first ad- equately powered RCT to test whether intensive BP control reduces dementia, may help clarify this issue in the near future. 11.4. Sexual Dysfunction and Hypertension An association among sexual dysfunction, atherosclerosis, and hypertension can be constructed from several epidemi- ology surveys, clinical trials, and cohort studies. Although these data converge to suggest that endothelial dysfunc- tion is a common denominator, the story is incomplete. Sexual dysfunction represents several domains in desire or interest, as well as physical limitations such as erectile dysfunction. 