Angiotensin-II receptor blockers may reduce Alzheimer’s disease risk

  • Barthold D & al.
  • PLoS ONE
  • 1 Jan 2018

  • from Sarfaroj Khan
  • Clinical Summaries
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Takeaway

  • Anti-hypertensive treatment (AHT) with renin-angiotensin system (RAS)-acting angiotensin-II receptor blockers (ARBs), in addition to lowering BP, may reduce Alzheimer’s disease (AD) risk, particularly in white and black women and white men.

Why this matters

  • Finding suggests that use of certain anti-hypertensives may offer benefits in patients with AD in addition to their BP lowering effects.

Study design

  • This retrospective cohort study compared AD diagnosis rates across 6 different AHT users (n=13,43,334) and 65 years of age or older (4,215,338 person-years).
  • Risks for AD were compared between RAS and non-RAS AHT users, and between angiotensin converting enzyme inhibitors (ACEIs) and ARB users by sex and race/ethnicity.
  • Funding: National Institutes of Health.

Key results

  • Compared with non-RAS-acting AHTs, RAS-acting AHTs were associated with significantly lower risk for AD in men (OR, 0.931; 95% CI, 0.895-0.969) vs women (OR, 0.985; 95% CI, 0.963-1.007).
  • This significant association was mainly driven by white males (OR, 0.932; 95% CI, 0.892-0.974).
  • ARBs were superior to ACEIs in lowering AD risk in both white men and white and black women:
    • Men (ARB users: OR, 0.834; 95% CI, 0.788-0.884 and ACEI users: OR, 0.978; 95% CI, 0.939-1.019).
    • Women (ARB users: OR, 0.941; 95% CI, 0.913-0.969 and ACEI users: OR, 1.022; 95% CI, 0.997-1.048).
  • There was no significant association between RAS-acting AHTs and AD risk in Hispanic men and women.

Limitations

  • AHT use and AD were imprecisely measured.