Blood Pressure Drug Found to Decrease the Risk of Dementia

Inclusion criteria were as follows: age 60 years at the index date, observation time of at least 12 months prior to the index date, and hypertension diagnosis prior to the index date. After applying similar inclusion criteria, dementia cases were matched to non-dementia controls using propensity scores based on age, sex, index year, and co-diagnoses (i.e. diabetes mellitus, hyperlipidemia, stroke including transient ischemic attack, coronary heart disease, depression, intracranial injury, Parkinson's disease, osteoporosis, and epilepsy). For the controls, the index date was that of a randomly selected visit between January 2013 and December 2017.

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The main outcome of the study was the incidence of dementia as a function of the use of antihypertensive drugs (i.e. diuretics, beta blockers, calcium channel blockers, angiotensin-converting enzyme [ACE] inhibitors, and angiotensin II receptor blockers).

Three logistic regression models were conducted to study the association between the use of antihypertensive drugs and dementia incidence after adjusting for blood pressure (first model: ever versus never use; second model: 3 versus <3 years of therapy; third model: ?5 versus <5 years of therapy).

The present study included 12,405 patients with dementia and 12,405 patients without dementia (mean age: 80.6 years; 61.3% women). The use of angiotensin II receptor blockers (odds ratios [ORs] ranging from 0.74 to 0.79), ACE inhibitors (ORs ranging from 0.85 to 0.88), calcium channel blockers (ORs ranging from 0.82 to 0.89), and beta blockers (OR=0.88) was associated with a decrease in dementia incidence. In patients treated with calcium channel blockers, increasing the duration of treatment decreased the incidence of dementia.

"Antihypertensive therapy alone cannot guarantee that dementia will never occur," noted corresponding author Prof. Karel Kostev, PhD, from the Epidemiology Department of IQVIA (Germany), "However, these findings highlight the importance of the prescription of antihypertensive drugs in the context of preventing hypertension-associated cognitive decline."

The authors of the study also note that: "further studies are needed to gain a better understanding of the medications associated with a decreased risk of dementia. We plan to investigate the role of lipid-lowering drugs, antidepressants, and further medications in the future."

The study is subject to some limitations, as the patients in the study were 60 or older, and this inclusion criterion was necessary for identifying dementia. However, previous research has shown that it is important for a life course-related prevention strategy to initiate hypertension treatment at a younger age. Moreover, data on patients' lifestyle factors, including smoking and physical activity, education, and job, were also lacking. The strengths of this study are the number of patients available for analysis, which allowed the use of a case-control design, and the use of real-world data, with different diagnoses and medications available for analysis



Source: Eurekalert