Edwin C K Tan1, Chengxuan Qiu2, Yajun Liang3, Rui Wang2, J Simon Bell4, Johan Fastbom2, Laura Fratiglioni2, Kristina Johnell2. 1. Center for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia; Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden. Electronic address: edwin.tan@monash.edu. 2. Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden. 3. Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. 4. Center for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.
Abstract
OBJECTIVE: To investigate the association between antihypertensive medication regimen intensity and risk of incident dementia in an older population. DESIGN: Prospective, longitudinal cohort study. PARTICIPANTS/ SETTING: A total of 1208 participants aged ≥78 years, free of dementia, and residing in central Stockholm at baseline (2001-2004). MEASUREMENTS: Participants were examined at 3- and 6-year follow-up to detect incident dementia. Data were collected through face-to-face interviews, clinical examinations, and laboratory tests. Data on antihypertensive use were obtained by a physician through patient self-report, visual inspection, or medical records. Cox proportional hazards models were used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between time-varying antihypertensive regimen intensity and incident dementia after adjusting for potential confounders. RESULTS: During the follow-up period, 125 participants were diagnosed with dementia. Participants who developed dementia were more likely to have vascular disease at baseline (66.4% vs 55.3%, P = .02). In fully adjusted analyses, the number of antihypertensive classes (HR 0.68, 95% CI 0.55-0.84) and total prescribed daily dose (HR 0.70, 95% CI 0.57-0.86) were significantly associated with reduced dementia risk. After considering all-cause mortality as a competing risk, the number (HR 0.75, 95% CI 0.62-0.91) and doses (HR 0.71, 95% CI 0.59-0.86) of antihypertensive classes, and the independent use of diuretics (HR 0.66, 95% CI 0.44-0.99), were significantly associated with lower dementia risk. CONCLUSIONS: Greater intensity of antihypertensive drug use among older people may be associated with reduced incidence of dementia.
OBJECTIVE: To investigate the association between antihypertensive medication regimen intensity and risk of incident dementia in an older population. DESIGN: Prospective, longitudinal cohort study. PARTICIPANTS/ SETTING: A total of 1208 participants aged ≥78 years, free of dementia, and residing in central Stockholm at baseline (2001-2004). MEASUREMENTS: Participants were examined at 3- and 6-year follow-up to detect incident dementia. Data were collected through face-to-face interviews, clinical examinations, and laboratory tests. Data on antihypertensive use were obtained by a physician through patient self-report, visual inspection, or medical records. Cox proportional hazards models were used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between time-varying antihypertensive regimen intensity and incident dementia after adjusting for potential confounders. RESULTS: During the follow-up period, 125 participants were diagnosed with dementia. Participants who developed dementia were more likely to have vascular disease at baseline (66.4% vs 55.3%, P = .02). In fully adjusted analyses, the number of antihypertensive classes (HR 0.68, 95% CI 0.55-0.84) and total prescribed daily dose (HR 0.70, 95% CI 0.57-0.86) were significantly associated with reduced dementia risk. After considering all-cause mortality as a competing risk, the number (HR 0.75, 95% CI 0.62-0.91) and doses (HR 0.71, 95% CI 0.59-0.86) of antihypertensive classes, and the independent use of diuretics (HR 0.66, 95% CI 0.44-0.99), were significantly associated with lower dementia risk. CONCLUSIONS: Greater intensity of antihypertensive drug use among older people may be associated with reduced incidence of dementia.
Authors: Giacomo Tini; Riccardo Scagliola; Fiammetta Monacelli; Giovanni La Malfa; Italo Porto; Claudio Brunelli; Gian Marco Rosa Journal: Cardiol Res Pract Date: 2020-05-05 Impact factor: 1.866
Authors: Jerome Robert; Emily B Button; Emma M Martin; Luke McAlary; Zoe Gidden; Megan Gilmour; Guilaine Boyce; Tara M Caffrey; Andrew Agbay; Amanda Clark; Judith M Silverman; Neil R Cashman; Cheryl L Wellington Journal: Mol Neurodegener Date: 2020-03-25 Impact factor: 14.195
Authors: Jan Willem van Dalen; Zachary A Marcum; Shelly L Gray; Douglas Barthold; Eric P Moll van Charante; Willem A van Gool; Paul K Crane; Eric B Larson; Edo Richard Journal: Neurology Date: 2020-11-05 Impact factor: 9.910