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Wednesday, 13 January 2010 11:19 GMT
Hypertension drug associated with reduced dementia, Alzheimer's risk
PARIS, Jan 13 (APM) - Angiotensin II receptor blockers are associated with reduced risk of developing dementia or Alzheimer's disease, according to an American study published online by the British Medical Journal (BMJ).
Several studies have suggested that hypertension treatment protects against risk of dementia and Alzheimer's disease, in particular. Angiotensin receptor blockers apparently preserve cognitive function, the authors say.
Angiotensin receptor blockers are commonly used, cheap, generic drugs prescribed for the treatment of hypertension.
But while the results show promise for the use of these drugs to fight dementia, Dr Susanne Sorensen, head of research at the Alzheimer's Society, said in a statement more research needs to be done before recommending their use in this area.
She said: "We have known for a while that it is important to control blood pressure from mid-life to reduce the risk of developing dementia. This new research not only adds to the evidence that treatments for high blood pressure could help stop the development of dementia but suggests that some of these treatments may be more suited to this than others."
Sorensen added: "The prospect of using already existing drugs to help in the fight against dementia is attractive. However, more research is needed to weigh up the benefits of this type of treatment as a protective tool."
STUDY
Nien-Chen Li of the Boston University School of Public Health and colleagues analysed a prospective cohort of over 819,000 cardiovascular patients aged 65 and over. The patients were mostly men and were monitored for four years.
Within the cohort, 11,703 patients were on an angiotensin receptor blocker, 93,484 were on lisinopril, an angiotensin converting enzyme (ACE) inhibitor and 714,304 took a "cardiovascular comparator" (any other cardiovascular drug, excluding statins).
Risk of dementia and Alzheimer's disease was significantly reduced with angiotensin receptor blockers compared with either lisinopril or the cardiovascular comparator.
Risk of Alzheimer's was reduced by 19% compared with lisinopril and by 16% compared with the cardiovascular comparator while risk of dementia was reduced by 19% and 24% respectively.
Furthermore, in participants with Alzheimer's disease, angiotensin receptor blockers were associated with a significantly lower risk of institutionalisation (-49%) and death (-17%), compared with the cardiovascular comparator. Similar reductions were observed for patients with dementia.
A dose-response effect was noted with the angiotensin receptor blockers, and when they were taken together with an ACE inhibitor, additive effects were noted. The combination of the two drugs was associated with a risk of dementia reduced by 46% and a risk of institutionalisation reduced by 67%, compared with an ACE inhibitor alone.
The researchers comment that theirs is the first study to "compare both risk of dementia and progression of dementia in users of angiotensin receptor blockers compared with users of a drug from the same class (lisinopril) or users of other drugs prescribed for cardiovascular disease".
The researchers conclude: "The study suggests that selective blockade of the angiotensin II receptor AT1 offers important health benefits to those with cognitive decline, and combined use of angiotensin receptor blockers and angiotensin converting enzyme inhibitors is associated with even greater benefits."
(BMJ, online publication of January 13)
cd/aki/hlc
[17755] 13/01/2010 11:19 GMT - CARDIO
Several studies have suggested that hypertension treatment protects against risk of dementia and Alzheimer's disease, in particular. Angiotensin receptor blockers apparently preserve cognitive function, the authors say.
Angiotensin receptor blockers are commonly used, cheap, generic drugs prescribed for the treatment of hypertension.
But while the results show promise for the use of these drugs to fight dementia, Dr Susanne Sorensen, head of research at the Alzheimer's Society, said in a statement more research needs to be done before recommending their use in this area.
She said: "We have known for a while that it is important to control blood pressure from mid-life to reduce the risk of developing dementia. This new research not only adds to the evidence that treatments for high blood pressure could help stop the development of dementia but suggests that some of these treatments may be more suited to this than others."
Sorensen added: "The prospect of using already existing drugs to help in the fight against dementia is attractive. However, more research is needed to weigh up the benefits of this type of treatment as a protective tool."
STUDY
Nien-Chen Li of the Boston University School of Public Health and colleagues analysed a prospective cohort of over 819,000 cardiovascular patients aged 65 and over. The patients were mostly men and were monitored for four years.
Within the cohort, 11,703 patients were on an angiotensin receptor blocker, 93,484 were on lisinopril, an angiotensin converting enzyme (ACE) inhibitor and 714,304 took a "cardiovascular comparator" (any other cardiovascular drug, excluding statins).
Risk of dementia and Alzheimer's disease was significantly reduced with angiotensin receptor blockers compared with either lisinopril or the cardiovascular comparator.
Risk of Alzheimer's was reduced by 19% compared with lisinopril and by 16% compared with the cardiovascular comparator while risk of dementia was reduced by 19% and 24% respectively.
Furthermore, in participants with Alzheimer's disease, angiotensin receptor blockers were associated with a significantly lower risk of institutionalisation (-49%) and death (-17%), compared with the cardiovascular comparator. Similar reductions were observed for patients with dementia.
A dose-response effect was noted with the angiotensin receptor blockers, and when they were taken together with an ACE inhibitor, additive effects were noted. The combination of the two drugs was associated with a risk of dementia reduced by 46% and a risk of institutionalisation reduced by 67%, compared with an ACE inhibitor alone.
The researchers comment that theirs is the first study to "compare both risk of dementia and progression of dementia in users of angiotensin receptor blockers compared with users of a drug from the same class (lisinopril) or users of other drugs prescribed for cardiovascular disease".
The researchers conclude: "The study suggests that selective blockade of the angiotensin II receptor AT1 offers important health benefits to those with cognitive decline, and combined use of angiotensin receptor blockers and angiotensin converting enzyme inhibitors is associated with even greater benefits."
(BMJ, online publication of January 13)
cd/aki/hlc
[17755] 13/01/2010 11:19 GMT - CARDIO
