Angiotensin Receptor Blockers Are Associated With a Lower Risk of Progression From Mild Cognitive Impairment to Dementia.

Abstract

BACKGROUND:

Previous studies found that antihypertensive medications (AHMs) acting on the renin-angiotensin system had the potential to reduce the progression from mild cognitive impairment to dementia. However, it remains unclear whether this association differs between ACE (angiotensin-converting enzyme) inhibitors and angiotensin receptor blockers.

METHODS:

We conducted a retrospective cohort study in the Alzheimer's Disease Neuroimaging Initiative among 403 participants with hypertension and mild cognitive impairment at baseline. Information on AHMs received during the follow-up period, including angiotensin receptor blockers, ACE inhibitors, beta-blockers, calcium channel blockers, and diuretics, were self-reported. Cox proportional hazards models adjusted for potential confounders were used in the time to event analysis with progression to dementia as outcome.

RESULTS:

Of the 403 participants, the mean (SD) age was 74.0 (7.3) years, 152 (37.7%) were female, 158 (39.2%) progressed to dementia over a median follow-up time of 3.0 years. Angiotensin receptor blockers were associated with a lower risk of progression to dementia as compared to ACE inhibitors (adjusted hazard ratio=0.45 [95% CI, 0.25-0.81]; P=0.023), other classes of AHMs (beta-blockers, calcium channel blockers, diuretics; adjusted hazard ratio, 0.49 [95% CI, 0.27-0.89]; P=0.037), and none of AHMs (adjusted hazard ratio, 0.31 [95% CI, 0.16-0.58]; P=0.001).

CONCLUSIONS:

In patients with hypertension and mild cognitive impairment, angiotensin receptor blockers were associated with a lower risk of progression to dementia compared with ACE inhibitors and other classes of AHMs. Our findings may have important implications for clinical practice but still warrant further investigations in larger prospective cohorts or clinical trials.

• Authors: Zhenhong Deng, Jingru Jiang, Jia Wang, Dong Pan, Yingying Zhu, Honghong Li, Xiaoni Zhang, Xiaohuan Liu, Yongteng Xu, Yi Li, Yamei Tang, Alzheimer’s Disease Neuroimaging Initiative†
• Journal: Hypertension (Dallas, Tex. : 1979) (Hypertension) Vol. 79 Issue 10 Pg. 2159-2169 (10 2022) ISSN: 1524-4563 [Electronic] United States
• PMID: 35766029 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Adrenergic beta-Antagonists
• Angiotensin Receptor Antagonists
• Angiotensin-Converting Enzyme Inhibitors
• Antihypertensive Agents
• Calcium Channel Blockers
• Diuretics

Topics

• Adrenergic beta-Antagonists (therapeutic use)
• Aged
• Alzheimer Disease (drug therapy)
• Angiotensin Receptor Antagonists (therapeutic use)
• Angiotensin-Converting Enzyme Inhibitors (pharmacology, therapeutic use)
• Antihypertensive Agents (therapeutic use)
• Calcium Channel Blockers (therapeutic use)
• Cognitive Dysfunction (complications, diagnosis)
• Diuretics (therapeutic use)
• Female
• Humans
• Hypertension (complications, drug therapy)
• Male
• Prospective Studies
• Retrospective Studies