Xi Pan1, Donglan Zhang2, Ji Haeng Heo3, Chanhyun Park3, Gang Li4, Christine M Dengler-Crish5, Yan Li6, Yian Gu7, Henry N Young8, Devin L Lavender8, Lu Shi9. 1. Department of Sociology, Texas State University, 601 University Drive, San Marcos, Texas, 78666, USA. x_p5@txstate.edu. 2. Division of Health Services Research, Department of Foundations of Medicine, New York University Long Island School of Medicine, 101 Mineola Boulevard, Suite 3-047, Mineola, NY, 11501, USA. 3. Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, College of Pharmacy-Health Outcomes and Pharmacy Practice, 2409 University Avenue, STOP A1930, Austin, TX, 78712-1120, USA. 4. Huazhong University of Science and Technology, Wuhan, China. 5. Department of Pharmaceutical Sciences, Northeast Ohio Medical University, 4209 St, OH-44, Rootstown, OH, 44272, USA. 6. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place Box 1077, New York, NY, 10029, USA. 7. Department of Neurology, Columbia University Irving Medical Center, 710 W 168th St, New York, NY, 10033, USA. 8. Department of Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia, 250 W. Green Street, Athens, GA, 30602, USA. 9. Department of Public Health Sciences, Clemson University, 507 Edwards Hall, Clemson, SC, 29634, USA.
Abstract
BACKGROUND: Epidemiological evidence on different classes of antihypertensives and risks of Alzheimer's disease and related dementias (ADRD) is inconclusive and limited. This study examined the association between antihypertensive use (including therapy type and antihypertensive class) and ADRD diagnoses among older adults with hypertension. METHODS: A retrospective, cross-sectional study was conducted, involving 539 individuals aged ≥ 65 years who used antihypertensives and had ADRD diagnosis selected from 2013 to 2018 Medical Expenditure Panel Survey (MEPS) data. The predictors were therapy type (monotherapy or polytherapy) and class of antihypertensives defined using Multum Lexicon therapeutic classification (with calcium channel blockers [CCBs] as the reference group). Weighted logistic regression was used to assess the relationships of therapy type and class of antihypertensives use with ADRD diagnosis, adjusting for sociodemographic characteristics and health status. RESULTS: We found no significant difference between monotherapy and polytherapy on the odds of ADRD diagnosis. As to monotherapy, those who used angiotensin-converting enzyme inhibitors (ACEIs) had significantly lower odds of developing AD compared to those who used CCBs (OR 0.36, 95 % CI 0.13-0.99). CONCLUSIONS: Findings of the study suggest the need for evidence-based drug therapy to manage hypertension in later adulthood and warrant further investigation into the mechanism underlying the protective effect of antihypertensives, particularly ACEIs, against the development of AD among older adults with hypertension.
BACKGROUND: Epidemiological evidence on different classes of antihypertensives and risks of Alzheimer's disease and related dementias (ADRD) is inconclusive and limited. This study examined the association between antihypertensive use (including therapy type and antihypertensive class) and ADRD diagnoses among older adults with hypertension. METHODS: A retrospective, cross-sectional study was conducted, involving 539 individuals aged ≥ 65 years who used antihypertensives and had ADRD diagnosis selected from 2013 to 2018 Medical Expenditure Panel Survey (MEPS) data. The predictors were therapy type (monotherapy or polytherapy) and class of antihypertensives defined using Multum Lexicon therapeutic classification (with calcium channel blockers [CCBs] as the reference group). Weighted logistic regression was used to assess the relationships of therapy type and class of antihypertensives use with ADRD diagnosis, adjusting for sociodemographic characteristics and health status. RESULTS: We found no significant difference between monotherapy and polytherapy on the odds of ADRD diagnosis. As to monotherapy, those who used angiotensin-converting enzyme inhibitors (ACEIs) had significantly lower odds of developing AD compared to those who used CCBs (OR 0.36, 95 % CI 0.13-0.99). CONCLUSIONS: Findings of the study suggest the need for evidence-based drug therapy to manage hypertension in later adulthood and warrant further investigation into the mechanism underlying the protective effect of antihypertensives, particularly ACEIs, against the development of AD among older adults with hypertension.
Authors: Renske Uiterwijk; Marjolein Huijts; Julie Staals; Rob P W Rouhl; Peter W De Leeuw; Abraham A Kroon; Robert J Van Oostenbrugge Journal: Am J Hypertens Date: 2015-08-12 Impact factor: 2.689
Authors: Antonis A Mougias; Antonis Politis; Constantine G Lyketsos; Venetsanos G Mavreas Journal: Int Psychogeriatr Date: 2010-08-12 Impact factor: 3.878
Authors: Emer R McGrath; Alexa S Beiser; Charles DeCarli; Kendra L Plourde; Ramachandran S Vasan; Steven M Greenberg; Sudha Seshadri Journal: Neurology Date: 2017-11-08 Impact factor: 9.910