TY - JOUR
T1 - Lower dementia risk with different classes of antihypertensive medication in older patients
AU - van Middelaar, Tessa
AU - van Vught, Lonneke A.
AU - van Charante, Eric P. Moll
AU - Eurelings, Lisa S. M.
AU - Ligthart, Suzanne A.
AU - van Dalen, Jan W.
AU - van den Born, Bert Jan H.
AU - Richard, Edo
AU - van Gool, Willem A.
PY - 2017
Y1 - 2017
N2 - 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.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.Results:At baseline, 1951 participants (55.3%) used AHM [mean age, 74.4 year (SD 2.5); mean SBP, 156.4mmHg (SD 21.5)]. In total, 986 participants (50.5%) used -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.Conclusion:Both use of CCBs and ARBs are independently associated with a decreased risk of dementia in older people
AB - 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.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.Results:At baseline, 1951 participants (55.3%) used AHM [mean age, 74.4 year (SD 2.5); mean SBP, 156.4mmHg (SD 21.5)]. In total, 986 participants (50.5%) used -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.Conclusion:Both use of CCBs and ARBs are independently associated with a decreased risk of dementia in older people
U2 - https://doi.org/10.1097/HJH.0000000000001411
DO - https://doi.org/10.1097/HJH.0000000000001411
M3 - Article
C2 - 28509727
SN - 0263-6352
VL - 35
SP - 2095
EP - 2101
JO - Journal of Hypertension
JF - Journal of Hypertension
IS - 10
ER -