Dementia Risk Is Reduced By Antihypertensive Medication, Regardless of Drug Class

No one antihypertensive medication drug class is more effective than any other for reducing the risk of dementia among individuals with hypertension, according to results of a new study.

To reach this conclusion, the researchers analyzed 6 prospective community-based studies that were published between January 1, 1980, and January 1, 2019, which in total comprised 31,090 well-phenotyped, dementia-free adults aged older than 55 years. The median follow-up time across all cohorts was 7 to 22 years.

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Baseline hypertension was defined as systolic blood pressure (SBP) of 140 mm Hg or greater or as diastolic blood pressure (DBP) of 90 mm Hg or greater (n=15,537). Baseline normal BP was defined as SBP less than 140 mm Hg and DBP less than 90 mm Hg (n=15,553).

According to the study authors, they assessed the association of incident dementia and clinical Alzheimer disease (AD) with the use of 5 antihypertensive medication classes.

In all, 3728 incident cases of dementia and 1741 incident AD diagnoses were recorded.

Among the hypertension group, individuals who took an antihypertensive medication had a reduced risk of developing dementia or AD compared with those who did not take an antihypertensive medication. However, no one drug class yielded significant differences in reducing dementia risk compared with other drug classes.

Among the normal BP group, there was no association between antihypertensive medication use and incident dementia or AD.

“Among people with hypertensive levels of blood pressure, use of any [antihypertensive medication] with efficacy to lower blood pressure might reduce the risk for dementia,” the researchers concluded. “These findings suggest future clinical guidelines for hypertension management should also consider the beneficial effect of [antihypertensive medication] on the risk for dementia.”

—Colleen Murphy

Reference:

Ding J, Davis-Plourde KL, Sedaghat S, et al. Antihypertensive medications and risk for incident dementia and Alzheimer's disease: a meta-analysis of individual participant data from prospective cohort studies. Lancet Neurol. 2020;19(1):61-70. https://doi.org/10.1016/S1474-4422(19)30393-X.