High blood pressure (BP) has been associated with an increased risk of cerebrovascular disease, stroke, and Alzheimer disease pathology. Epidemiologic studies are consistent in showing that high BP, particularly in midlife, is a risk factor for the development of dementia in late life. However, supporting randomized evidence of the inference that BP-lowering therapy can prevent dementia has been slow in coming over the last 30 years. The most recent randomized trial, the Systolic Blood Pressure Intervention Trial—Memory and Cognition in Decreased Hypertension (SPRINT-MIND), therefore, makes a pivotal contribution to the field, reemphasizing broader public health benefits of BP lowering and directing future research.