Antihypertensive Use and the Risk of Alzheimer’s Disease and Related Dementias among Older Adults in the USA

Pan, Xi; Zhang, Donglan; Heo, Ji Haeng; Park, Chanhyun; Li, Gang; Crish, Samuel D.; Li, Yan; Gu, Yian; Young, Henry N.; Lavender, Devin L.; Shi, Lu

doi:10.1007/s40266-022-00981-8

Cited by 2 publications

(4 citation statements)

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“…Additional clinical risk factors that can be assessed and treated could involve reducing excessive use of pharmacological treatments (i.e. polypharmacy) for hypertension and diabetes (resulting in hypotension, hypoglycemia low sugar level and lower heart rate (bradycardia) [5,19].…”

Section: Discussionmentioning

confidence: 99%

“…Our ndings indicated that these factors can be identi ed early, and suggest that CVRF could be treated at pre-dementia stages in order to delay vascular and neurodegenerative progression. In support of examining early CVRF parameters as pre-dementia risk factors, earlier studies have shown that low cardiac index (low blood pressure or low pulse) followed by cardiac lesion or antihypertensive drugs is associated with increased incidents of vascular dementia and Alzheimer disease [5,12]. In addition, Diabetes mellitus adult type 2 (poorly controlled blood sugar) increases the risk of developing Alzheimer's disease.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, new research ndings seem to support the connection between uncommon or novel cardio-vascular risk factors (CVRF) and cognitive decline observed in early prodromal or mild dementia stages [5][6][7][8]. In light of these ndings, it is necessary to re-evaluate preceding cerebrovascular risk factors in elderly pre-dementia geriatric patients that may distinguish a unique pre-MVAD prodromaldementia population that can be treated early to suppress the severity or delay the onset of pervasive dementia symptoms.…”

Section: Introductionmentioning

confidence: 95%

“…Currently, clinicians can apply atrial ablation procedures and induce a return to sinus rhythm and no formation of emboli. The same with correction of aortic stenosis or stiffness and discontinuing of antihypertensive class medication that reduce cardiac index [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Early disease-specific characteristics for identifying Mixed Vascular-Alzheimer's Dementia in geriatric patients

Jaul,

Factor,

Meiron

2023

Preprint

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Purpose Mixed Vascular-Alzheimer's Dementia (MVAD) is coexistence of both Alzheimer's disease and cerebrovascular disease (CVD) in the same patient. Thus, the current investigation focused on retrospectively classifying and diagnosing older geriatric patients at risk for dementia with both vascular risk factors and neuro-atrophy factors in Alzheimer's disease (AD)versus patients with nonvascular-AD etiology. Methods The study evaluated demographic and clinical data collected from a cohort of 192 geriatric out-patients (age range = 60–97 years) admitted for one baseline and one follow-up clinical consultations within a period of three years. Mini Mental State Examination (MMSE) scores and cardiovascular risk factors were reevaluated and utilized in the assessment of basic cognitive functioning and clinical diagnosis of MVAD and AD dementia subgroups during follow-up visits. Results A relatively high prevalence of MVAD diagnosis was found across the entire sample (36%). MVAD diagnosis was significantly higher in men with 59% prevalence, while AD diagnosis without vascular etiology was significantly higher in women with 69% prevalence. MVAD diagnosis was more pronounced under the age of 85, while AD diagnosis without vascular history was significantly higher in ages 85 years or older. Importantly, non-palpations of peripheral pulse and atrial fibrillation-type arrhythmia were found to be significant early risk factors related to prospective MVAD diagnosis (p < .008, OR = 30, p < .009, OR = .005). Conclusion Early comprehensive clinical evaluation of specific vascular risk factors prior to dementia onset could putatively predict the onset of MVAD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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Early disease-specific characteristics for identifying Mixed Vascular-Alzheimer's Dementia in geriatric patients

Jaul,

Factor,

Meiron

2023

Preprint

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Angiotensin-II stimulating vs. inhibiting antihypertensive drugs and the risk of Alzheimer's disease or related dementia in a large cohort of older patients with colorectal cancer

Schulz

2023

Front. Cardiovasc. Med.

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BackgroundSeveral previous studies showed that patients who received angiotensin II–stimulating antihypertensive medications had a lower incident dementia rate than those angiotensin II–inhibiting antihypertensive users, but no study has been conducted in long-term cancer survivors.ObjectivesTo determine the risk of Alzheimer's disease (AD) and related dementia (ADRD) associated with the types of antihypertensive medications in a large cohort of survivors with colorectal cancer in 2007–2015 with follow-up from 2007 to 2016.MethodsWe identified 58,699 men and women with colorectal cancer aged 65 or older from the Surveillance, Epidemiology, and End Results (SEER)—Medicare linked database in 17 SEER areas in 2007–2015 with follow-up to 2016, who were free of any diagnosed ADRD at the baseline (within 12 months prior to and 12 months after the date of diagnosis for colorectal cancer). All patients who were defined as having hypertension by ICD diagnosis code or received antihypertensive drugs during this baseline 2-year period were classified into 6 groups based on whether they received angiotensin-II stimulating or inhibiting antihypertensive drugs.ResultsCrude cumulative incidence rates of AD and ADRD were similar between those who received angiotensin II–stimulating antihypertensive medications (4.3% and 21.7%) and those receiving angiotensin II–inhibiting antihypertensive medications (4.2% and 23.5%). As compared to patients who received angiotensin II–stimulating antihypertensive drugs, those who received angiotensin II–inhibiting antihypertensives were significantly more likely to develop AD (adjusted hazard ratio: 1.15, 95% CI: 1.01–1.32), vascular dementias (1.27, 1.06–1.53), and total ADRD (1.21, 1.14–1.28) after adjusting for potential confounders. These results remained similar after adjusting for medication adherence and considering death as a competing risk.ConclusionsThe risk of AD and ADRD in patients with hypertension who received angiotensin II–inhibiting antihypertensive medications was higher than in those receiving angiotensin II–stimulating antihypertensive drugs in patients with colorectal cancer.

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Antihypertensive Use and the Risk of Alzheimer’s Disease and Related Dementias among Older Adults in the USA

Cited by 2 publications

References 44 publications

Early disease-specific characteristics for identifying Mixed Vascular-Alzheimer's Dementia in geriatric patients

Early disease-specific characteristics for identifying Mixed Vascular-Alzheimer's Dementia in geriatric patients

Angiotensin-II stimulating vs. inhibiting antihypertensive drugs and the risk of Alzheimer's disease or related dementia in a large cohort of older patients with colorectal cancer

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