Reducing the Risk of Dementia: Efficacy of Long-Term Treatment of Hypertension
Abstract
Background and Purpose— The efficacy of treating older persons for hypertension remains controversial. Although clinical trials suggest no short-term harm, or some benefits, there are little data on the effect on cognitive function of long-term antihypertensive treatment. We evaluated the risk of dementia and cognitive decline associated with duration of antihypertensive treatment. Methods— Data are from the Honolulu Asia Aging Study on Japanese American men followed since 1965. The subjects included in this analysis were hypertensive from midlife and dementia-free in 1991 (mean age 76.7 years). In 1991, 1994 and 1997, global cognitive function was assessed with the Cognitive Abilities Screening Instrument (CASI) and dementia by a standardized examination using international criteria. The sample was grouped by treatment duration (never-treated hypertensives (NTH), <5 years, 5 to 12 years, >12 years). Normotensive subjects up to 1991 were included in the analysis as a control group. Results— For each additional year of treatment there was a reduction in the risk of incident dementia (hazard ratio [HR]=0.94, 95% CI, 0.89 to 0.99). The risk for dementia in subjects with >12 years of treatment was lower compared to NTH (HR for dementia=0.40; 95% CI, 0.22 to 0.75 and for Alzheimer disease HR=0.35; 95% CI, 0.16 to 0.78) and was similar to the normotensives. Nondemented subjects with 5 to 12 years of treatment had lower yearly CASI decline compared to NTH. Conclusions— Results suggest that in hypertensive men, the duration of the antihypertensive treatment is associated with a reduced risk for dementia and cognitive decline.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In 3 studies there was no association between hypertension treatment and Alzheimer disease risk, whereas in others there was a decreased Alzheimer disease risk among those receiving antihypertensive treatment.
“In 3 studies there was no association between hypertension treatment and risk of Alzheimer disease,432–434 whereas in others there was a decreased risk of Alzheimer disease among those receiving antihypertensive treatment.429,431,435–437”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E. M. (1984) · Neurology · doi:10.1212/wnl.34.7.939 · Cited by 27,915 · see citing works
(2000) · New England Journal of Medicine · doi:10.1056/nejm200001203420301 · Cited by 8,663 · see citing works
Restriction isotyping of human apolipoprotein E by gene amplification and cleavage with HhaI.
Hixson, J., & Vernier, D. (1990) · Journal of Lipid Research · doi:10.1016/s0022-2275(20)43176-1 · Cited by 2,933 · see citing works
World Health Organization, I. S. O. H. W. G. (2003) · Journal of Hypertension · doi:10.1097/00004872-200311000-00002 · Cited by 2,654 · see citing works
15-year longitudinal study of blood pressure and dementia
Skoog, I., Nilsson, L., Persson, G., Lernfelt, B., Landahl, S., Palmertz, B., Andreasson, L.-A., Odén, A., & Svanborg, A. (1996) · The Lancet · doi:10.1016/s0140-6736(96)90608-x · Cited by 1,726 · see citing works
Forette, F., Seux, M.-L., Staessen, J. A., Thijs, L., Birkenhäger, W. H., Babarskiene, M.-R., Babeanu, S., Bossini, A., Gil-Extremera, B., Girerd, X., et al. (1998) · The Lancet · doi:10.1016/s0140-6736(98)03086-4 · Cited by 1,441 · see citing works
The Study on Cognition and Prognosis in the Elderly (SCOPE)
Lithell, H., Hansson, L., Skoog, I. G., Elmfeldt, D., Albert Hofman, D., Olofsson, B., Trenkwalder, P., & Zanchetti, A. (2003) · Journal of Hypertension · doi:10.1097/00004872-200305000-00011 · Cited by 1,413 · see citing works
Chui, H. C., Victoroff, J. I., Margolin, D., Jagust, W., Shankle, R., & Katzman, R. (1992) · Neurology · doi:10.1212/wnl.42.3.473 · Cited by 1,201 · see citing works
(2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.9.1069 · Cited by 988 · see citing works
The Association Between Midlife Blood Pressure Levels and Late-Life Cognitive Function
Launer, L. J. (1995) · JAMA · doi:10.1001/jama.1995.03530230032026 · Cited by 944 · see citing works
Self-citationTeng, E. L., Hasegawa, K., Homma, A., Imai, Y., Larson, E. B., Graves, A. B., Sugimoto, K., Yamaguchi, T., Sasaki, H., Chiu, D., et al. (1994) · International Psychogeriatrics · doi:10.1017/s1041610294001602 · Cited by 910 · see citing works
Self-citationForette, F. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.18.2046 · Cited by 898 · see citing works
Untreated Blood Pressure Level Is Inversely Related to Cognitive Functioning: The Framingham Study
Elias, M. F., Wolf, P. A., D’Agostino, R. B., Cobb, J. L., & White, L. R. (1993) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a116868 · Cited by 652 · see citing works
Self-citationHypertension and cerebral white matter lesions in a prospective cohort study
de Leeuw, F. ‐., de Groot, J. C., Oudkerk, M., Witteman, J. C. M., Hofman, A., van Gijn, J., & Breteler, M. M. B. (2002) · Brain · doi:10.1093/brain/awf077 · Cited by 614 · see citing works
Prevalence of Dementia in Older Japanese-American Men in Hawaii: The Honolulu-Asia Aging Study
White, L. (1996) · JAMA · doi:10.1001/jama.1996.03540120033030 · Cited by 437 · see citing works
Self-citationPrince, M. J., Bird, A. S., Blizard, R., & MANN, A. H. (1996) · BMJ · doi:10.1136/bmj.312.7034.801 · Cited by 317 · see citing works
Morbidity and mortality in hypertensive adults with a low ankle/arm blood pressure index
Newman, A. B. (1993) · JAMA · doi:10.1001/jama.270.4.487 · Cited by 300 · see citing works
Impact of the Treatment of Isolated Systolic Hypertension on Behavioral Variables
Applegate, W. B. (1994) · Archives of Internal Medicine · doi:10.1001/archinte.154.19.2154 · Cited by 278 · see citing works
Morbidity and Mortality in Hypertensive Adults With a Low Ankle/Arm Blood Pressure Index
Newman, A. B. (1993) · JAMA · doi:10.1001/jama.1993.03510040091035 · Cited by 257 · see citing works
Antihypertensive drugs and incidence of dementia: the Rotterdam Study
in’t Veld, B. A., Ruitenberg, A., Hofman, A., Stricker, B. H. C., & Breteler, M. M. B. (2001) · Neurobiology of Aging · doi:10.1016/s0197-4580(00)00241-4 · Cited by 254 · see citing works
Demonstrating the case that AD is a vascular disease: epidemiologic evidence
Launer, L. J. (2002) · Ageing Research Reviews · doi:10.1016/s0047-6374(01)00364-5 · Cited by 227 · see citing works
Self-citationOccurrence and Progression of Dementia in a Community Population Aged 75 Years and Older
Guo, Z., Fratiglioni, L., Zhu, L., Fastbom, J., Winblad, B. G., & Viitanen, M. H. (1999) · Archives of Neurology · doi:10.1001/archneur.56.8.991 · Cited by 215 · see citing works
Applegate, W. B. (1994) · Archives of Internal Medicine · doi:10.1001/archinte.1994.00420190047006 · Cited by 193 · see citing works
Hypertension in the Very Elderly Trial (HYVET)
Bulpitt, C. J., FLETCHER, A. E., Beckett, N. S., et al. (2001) · Drugs & Aging · doi:10.2165/00002512-200118030-00001 · Cited by 171 · see citing works
Tortuosity of the White Matter Medullary Arterioles Is Related to the Severity of Hypertension
Hiroki, M., Miyashita, K., & Oda, M. (2002) · Cerebrovascular Diseases · doi:10.1159/000057850 · Cited by 153 · see citing works
Blood Pressure, Cognitive Functions, and Prevention of Dementias in Older Patients With Hypertension
Birkenhäger, W. H., Forette, F., Seux, M., Wang, J.-G., & Staessen, J. A. (2001) · Archives of Internal Medicine · doi:10.1001/archinte.161.2.152 · Cited by 144 · see citing works
Accuracy of clinical criteria for AD in the Honolulu–Asia Aging Study, a population-based study
Petrovitch, H., White, L. R., Ross, G. W., Steinhorn, S. C., Li, C. Y., Masaki, K., Davis, D. G., Nelson, J., Hardman, J. M., Curb, J. D., et al. (2001) · Neurology · doi:10.1212/wnl.57.2.226 · Cited by 136 · see citing works
Self-citationSyme, S. L., Marmot, M. G., Kagan, A., Kato, H., & Rhoads, G. (1975) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a112185 · Cited by 131 · see citing works
Alzheimer's disease : advances in clinical and basic research
Corain, B. (1993) · Medical Entomology and Zoology · Cited by 122 · see citing works
The Effects of Antihypertensive Treatment on Cognitive Function: Results from the HOPE Study
Starr, J. M., Whalley, L. J., & Deary, I. J. (1996) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1996.tb06412.x · Cited by 113 · see citing works
Embracing Complexity: A Consideration of Hypertension in the Very Old
Goodwin, J. S. (2003) · The Journals of Gerontology Series A · doi:10.1093/gerona/58.7.m653 · Cited by 112 · see citing works
Feigin, V. L., Ratnasabapathy, Y., & Anderson, C. S. (2005) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2004.11.020 · Cited by 103 · see citing works
Hajjar, I. M., Miller, K., & Hirth, V. (2002) · The Journals of Gerontology Series A · doi:10.1093/gerona/57.8.m487 · Cited by 64 · see citing works
APOE-ε4 predicts incident AD in Japanese-American men: The Honolulu–Asia Aging Study
Havlik, R. J., Izmirlian, G., Petrovitch, H., Ross, G. W., Masaki, K., Curb, J. D., Saunders, A. M., Foley, D. J., Brock, D. B., Launer, L. J., et al. (2000) · Neurology · doi:10.1212/wnl.54.7.1526 · Cited by 62 · see citing works
Self-citationThe treatment of hypertension in older people and its effect on cognitive function
Prince, M. J. (1997) · Biomedicine & Pharmacotherapy · doi:10.1016/s0753-3322(97)81597-1 · Cited by 26 · see citing works
Treating Isolated Systolic Hypertension in the Elderly
Howard, P. A. (1994) · Annals of Pharmacotherapy · doi:10.1177/106002809402800313 · Cited by 3 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd Edition, Revised. Washington DC: America Psy- chiatric Association 1987.
Cited by
Sorted by citations
Gorelick, P. B., Scuteri, A., Black, S. E., DeCarli, C., Greenberg, S. M., Iadecola, C., Launer, L. J., Laurent, S., Lopez, O. L., Nyenhuis, D., et al. (2011) · Stroke · doi:10.1161/str.0b013e3182299496 · Cited by 3,811 · see citing works
Self-citationEpidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention
Qiu, C., Kivipelto, M., & von Strauss, E. (2009) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2009.11.2/cqiu · Cited by 1,261 · see citing works
Iadecola, C., Yaffe, K., Biller, J., Bratzke, L. C., Faraci, F. M., Gorelick, P. B., Gulati, M., Kamel, H., Knopman, D. S., Launer, L. J., et al. (2016) · Hypertension · doi:10.1161/hyp.0000000000000053 · Cited by 746 · see citing works
Self-citationPlassman, B. L., Williams, J. W., Burke, J. R., Holsinger, T., & Benjamin, S. (2010) · Annals of Internal Medicine · doi:10.7326/0003-4819-153-3-201008030-00258 · Cited by 681 · see citing works
The Aging Cardiovascular System
Paneni, F., Diaz Cañestro, C., Libby, P., Lüscher, T. F., & Camici, G. G. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.01.064 · Cited by 618 · see citing works
Hypertension and Cerebrovascular Dysfunction
Iadecola, C., & Davisson, R. L. (2008) · Cell Metabolism · doi:10.1016/j.cmet.2008.03.010 · Cited by 557 · see citing works
The Impact of Disease Comorbidities in Alzheimer’s Disease
Santiago, J. A., & Potashkin, J. A. (2021) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2021.631770 · Cited by 259 · see citing works
Anderson, C., Teo, K., Gao, P., Arima, H., Dans, A., Unger, T., Commerford, P., Dyal, L., Schumacher, H., Pogue, J., et al. (2011) · The Lancet Neurology · doi:10.1016/s1474-4422(10)70250-7 · Cited by 216 · see citing works
Duration of antihypertensive drug use and risk of dementia: A prospective cohort study
Haag, M. D. M., Hofman, A., Koudstaal, P. J., Breteler, M. M. B., & Stricker, B. H. C. (2009) · Neurology · doi:10.1212/01.wnl.0000345062.86148.3f · Cited by 140 · see citing works
Prevention of Vascular Cognitive Impairment
Dichgans, M., & Zietemann, V. (2012) · Stroke · doi:10.1161/strokeaha.112.651778 · Cited by 107 · see citing works
Qiu, C., Xu, W., & Fratiglioni, L. (2010) · Journal of Alzheimer's Disease · doi:10.3233/jad-2010-091663 · Cited by 107 · see citing works
Carotid atherosclerosis and cognitive decline in patients with Alzheimer's disease
Silvestrini, M., Gobbi, B., Pasqualetti, P., Bartolini, M., Baruffaldi, R., Lanciotti, C., Cerqua, R., Altamura, C., Provinciali, L., & Vernieri, F. (2009) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2007.11.008 · Cited by 78 · see citing works
Blood Pressure and Cognition: Factors That May Account for Their Inconsistent Association
Power, M. C., Tchetgen Tchetgen, E. J., Sparrow, D., Schwartz, J., & Weisskopf, M. G. (2013) · Epidemiology · doi:10.1097/ede.0b013e3182a7121c · Cited by 63 · see citing works
Mechanistic Insights for Drug Repurposing and the Design of Hybrid Drugs for Alzheimer’s Disease
Padhi, D., & Govindaraju, T. (2022) · Journal of Medicinal Chemistry · doi:10.1021/acs.jmedchem.2c00335 · Cited by 47 · see citing works
- Authors
- Peila, R., White, L. R., Masaki, K., Petrovitch, H., & Launer, L. J.
- Affiliations
- University of Hawaiʻi at Mānoa (US)
- Venue
- Stroke
- Published
- 2006-05
- Volume
- 37
- Issue
- 5
- Pages
- 1165-1170
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W2152784998
- Cited by
- 181
- References
- 37
- Citations by year
- 2025: 1 · 2024: 6 · 2023: 4 · 2022: 4 · 2021: 5 · 2020: 9 · 2019: 6 · 2018: 5 · 2017: 6 · 2016: 12 · 2015: 10 · 2014: 4 · 2013: 13 · 2012: 6
- FWCI
- 12.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (N01-AG-4–2149)
- National Institute on Aging (N01‐AG‐4‐2149, UO1-AG-0-9349-03)
- National Heart, Lung, and Blood Institute (N01 HC 05102)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Keywords
- dementia risk, antihypertensive therapy, hypertension, treatment duration, cognitive decline, Alzheimer's disease, older men, Honolulu-Asia Aging Study, Japanese Americans, cognitive function
- MeSH terms
- Age Factors, Aged, Antihypertensive Agents, Cognition, Dementia, Female, Humans, Hypertension, Male, Sex Factors, Time Factors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
