1. Effect of renin‐angiotensin system antihypertensive medication use on cognitive function in diabetes mellitus with obesity or overweight: An ancillary study to the Action for Health in Diabetes (Look <scp>AHEAD</scp> ) trial
- Author
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Whitney Wharton, Andrea Anderson, Kathleen M. Hayden, Owen T Carmichael, Jeanne M Clark, José A. Luchsinger, Mark Espeland, and Sevil Yasar
- Subjects
Renin-Angiotensin System ,Cognition ,Endocrinology ,Diabetes Mellitus, Type 2 ,Endocrinology, Diabetes and Metabolism ,Internal Medicine ,Humans ,Cognitive Dysfunction ,Dementia ,Obesity ,Overweight ,Antihypertensive Agents - Abstract
To determine whether antihypertensive medication (AHM) acting through the renin angiotensin system (RAS-AHM), compared with other AHM, can mitigate effects on cognitive function and risk for impairment in a population with type 2 diabetes mellitus (T2DM).This secondary analysis of the randomized controlled Action for Health in Diabetes (Look AHEAD) study included 712 community-dwelling participants who were followed over 15 years. Logistic regression was used to relate RAS-AHM use to cognitive impairment, and linear regression was used to relate RAS-AHM use to domain-specific cognitive function after adjusting for potential confounders.A total of 563 individuals reported RAS-AHM use and 149 reported other-AHM use during the study. RAS-AHM users have college or higher education (53%), had higher baseline glycated haemoglobin (57 mmol/mol), and reported higher diabetes medication use (86%), while other-AHM users were more likely to be White (72%), obese (25%) and to have cardiovascular history (19%). RAS-AHM use was not associated with a reduced risk of dementia compared with other-AHM use. We did observe better executive function (Trail Making Test, part B, P 0.04), processing speed (Digit Symbol Substitution Test, P 0.004), verbal memory (Rey Auditory Verbal Learning Test-delayed recall, P 0.005), and composite score (P 0.008) among RAS-AHM users compared with other-AHM users.In this sample of adults with T2DM, free of dementia at baseline, we observed a slower decline in processing speed, executive function, verbal memory, and composite score among RAS-AHM users.
- Published
- 2022
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