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Associations of Anti-Hypertensive Treatments with Alzheimer's Disease, Vascular Dementia, and Other Dementias
Abstract
We investigated whether angiotensin II receptor blockers (ARBs) and angiotensin converting enzyme inhibitors (ACE-Is) are more strongly associated with Alzheimer's disease (AD), vascular dementia (VaD), and other dementias, than other anti-hypertensive drugs. We conducted a nested case-control analysis within the UK general practice research database, with prospectively recorded anti-hypertensive prescribing data. We sampled cases aged ≥60 years and diagnosed between 1997–2008 (5,797 with AD, 2,186 with VaD, 1,214 with unspecified/other dementia) which were matched to up to four controls by age, general practice and gender. We computed odds-ratios and dose response effects for AD, vascular and unspecified/other dementia, comparing those prescribed ARBs or ACE-Is for at least six months with patients prescribed other anti-hypertensives. We controlled for matching factors, co-morbidities, smoking status, an area measure of socioeconomic status, consultation rate and blood pressure and accounted for reverse causality by introducing time-lags of up to eight years prior to diagnosis/index date. Patients diagnosed with AD, vascular and unspecified/other dementia had fewer prescriptions for ARBs and ACE-Is. Inverse associations with AD were strongest for ARBs (odds-ratio; 0.47, 95%CI, 0.37–0.58) compared with ACE-Is (odds-ratio; 0.76, 95%CI, 0.69–0.84) (p difference < 0.001). Associations of ARBs with AD were stronger than for vascular dementia (p difference = 0.01) and unspecified/other dementia (p difference = 0.23). There were inverse dose-response relationships between ARBs and ACE-Is with AD (both p trend < 0.01). The inverse association of ACE-Is with AD diminished when using longer time lags but the ARB-AD association persisted. Patients with AD were around half as likely to be prescribed ARBs. Further randomized controlled trial evidence is required to rigorously test these findings.
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From Neuroinflammation and cytokine abnormality in major depression: cause or consequence in that illness? (2016) · cites this paper as [70]
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Metadata
- Authors
- Davies, N. M., Kehoe, P. G., Ben-Shlomo, Y., & Martin, R. M.
- Affiliations
- University of Bristol (GB)
- Frenchay Hospital (GB)
- School of Social and Community Medicine, Faculty of Medicine and Dentistry, University of Bristol, Canynge Hall, Bristol, UK
- Corresponding author
- Kehoe, Patrick G
- Venue
- Journal of Alzheimer’s Disease
- Publisher
- SAGE Publications
- Published
- 2011-10-04
- Volume
- 26
- Issue
- 4
- Pages
- 699-708
- ISSN
- 1387-2877 (ISSN-L)
- 1875-8908
- OpenAlex
- W1828947725
- Cited by
- 212
- References
- 41
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 12 · 2023: 9 · 2022: 9 · 2021: 16 · 2020: 17 · 2019: 8 · 2018: 14 · 2017: 12 · 2016: 28 · 2015: 15 · 2014: 18 · 2013: 24 · 2012: 19
- FWCI
- 14.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Alzheimer s Disease (publishedVersion)
- PubMed (publishedVersion)
- Explore Bristol Research (publishedVersion)
- Bristol Research (University of Bristol) (submittedVersion)
- Funders
- North Bristol NHS Trust
- Medical Research Council
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- angiotensin receptor blockers, ACE inhibitors
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Angiotensin-Converting Enzyme Inhibitors, Antihypertensive Agents, Blood Pressure, Data Interpretation, Statistical, Dementia, Dose-Response Relationship, Drug, Female, United Kingdom, Humans, Male, Socioeconomic Factors, Dementia, Vascular, Case-Control Studies, Databases, Factual, Angiotensin II Type 1 Receptor Blockers
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