- Older adults with high BP had reduced risks for dementia and Alzheimer’s disease (AD) if they used antihypertensive medication, regardless of drug class.
Why this matters
- Limited options for preventing and treating dementia.
- With median follow-up ranging from 7 to 22 years, 3728 incident cases of dementia and 1741 incident cases of Alzheimer’s disease.
- Among the 50% of participants having baseline high BP, antihypertensive medication users had reduced adjusted risks for:
- Dementia (HR, 0.88; 95% CI, 0.79-0.98).
- Alzheimer’s disease (HR, 0.84; 95% CI, 0.73-0.97).
- No significant differences in risk between 1 drug class vs all others.
- APOE ε4 carriers with high BP who used antihypertensive medication had more marked reduction in dementia risk (HR, 0.77; 95% CI, 0.64-0.93).
- In contrast, among participants having normal BP, antihypertensive medication use did not protect against dementia or Alzheimer’s disease.
- Meta-analysis of individual participant data from 6 large prospective observational cohort studies among 31,090 community-dwelling dementia-free adults older than 55 years published 1980-2018.
- Main outcomes: all-cause dementia, Alzheimer’s disease.
- Funding: Alzheimer’s Drug Discovery Foundation; National Institute on Aging Intramural Research Program.
- Potential misclassification of dementia type.
- Survival may have differed by medication use.
- Possible residual confounding.