Antihypertensives and risk for dementia and Alzheimer's disease

  • Ding J & al.
  • Lancet Neurol
  • 1 Jan 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In patients with hypertension, the use of any antihypertensive medications (AHMs) might be associated with a reduction in the risk for dementia and Alzheimer’s disease (AD) with no significant differences by use of a specific drug class.

Why this matter

  • Findings suggest future clinical guidelines for the management of hypertension should also consider the beneficial effect of AHM on dementia risk.

Study design

  • 6 prospective studies including 31,090 participants (age ≥ 55 years; 15,553 with normal BP and 15,537 with high BP) met eligibility criteria.
  • Funding: The Alzheimer’s Drug Discovery Foundation and others.

Key results

  • During 302,490 person-years of follow-up, 3728 had incident dementia and 1741 had incident AD.
  • In patients with high BP, those using any AHM were at a lower risk for dementia (HR, 0.88; 95% CI, 0.79-0.98; P=.019) and AD (HR, 0.84; 95% CI, 0.73-0.97; P=.021) vs those not using AHM.
  • The risk for dementia did not differ between one drug class vs all others.
  • In patients with normal BP, no significant association was observed between AHM use and incident dementia or AD (HR, 1.03; 95% CI, 0.92-1.15).

Limitations

  • Heterogeneity among studies.
  • Risk of residual confounding.