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Lower dementia risk with different classes of antihypertensive medication in older patients.
- Source :
-
Journal of hypertension [J Hypertens] 2017 Oct; Vol. 35 (10), pp. 2095-2101. - Publication Year :
- 2017
-
Abstract
- Objective: Use of antihypertensive medication (AHM) is potentially associated with a reduced risk of dementia. Both calcium channel blockers (CCBs) and angiotensin receptor blockers (ARBs) are suggested to have a more pronounced protective effect. We aimed to study the association between different classes of AHM and dementia in older people.<br />Methods: A subgroup of community-dwelling older people using AHM included in the 'Prevention of Dementia by Intensive Vascular Care' randomized controlled trial was studied. Incident dementia rates in participants with different AHM classes (mono and combination therapy) were compared with dementia rates in participants with any other AHM.<br />Results: At baseline, 1951 participants (55.3%) used AHM [mean age, 74.4 year (SD 2.5); mean SBP, 156.4 mmHg (SD 21.5)]. In total, 986 participants (50.5%) used β-blockers, 798 diuretics (40.9%), 623 angiotensin- converting enzyme inhibitors (31.9%), 522 CCBs (26.8%), and 402 ARBs (20.6%). After 6.7 years (interquartile range 6.0-7.3) of follow-up, 136 participants (7.0%) developed dementia. Both use of CCBs [hazard ratio 0.56, 95% confidence interval (95% CI) 0.36-0.87] and ARBs (hazard ratio 0.60, 95% CI 0.37-0.98) were independently associated with a decreased risk of dementia. The association of CCBs with dementia was most apparent in participants without a history of cardiovascular disease (hazard ratio 0.38, 95% CI 0.18-0.81) and with uncontrolled hypertension (hazard ratio 0.26, 95% CI 0.11-0.61). SBP was not significantly lower in participants using CCBs or ARBs.<br />Conclusion: Both use of CCBs and ARBs are independently associated with a decreased risk of dementia in older people.
- Subjects :
- Aged
Angiotensin Receptor Antagonists adverse effects
Angiotensin Receptor Antagonists therapeutic use
Calcium Channel Blockers adverse effects
Calcium Channel Blockers therapeutic use
Follow-Up Studies
Humans
Antihypertensive Agents adverse effects
Antihypertensive Agents therapeutic use
Dementia epidemiology
Hypertension drug therapy
Hypertension epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1473-5598
- Volume :
- 35
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Journal of hypertension
- Publication Type :
- Academic Journal
- Accession number :
- 28509727
- Full Text :
- https://doi.org/10.1097/HJH.0000000000001411