Can Antihypertensives Reduce the Risk of Dementia? The Answer Suggests the Angiotensin Hypothesis and a Post-Hoc Analysis of an Observational Study
The use of antihypertensives that do not reduce angiotensin II levels, such as angiotensin receptor blockers (ARBs, i.e., sartans) and calcium channel blockers (CCBs), has been associated with a lower risk of dementia in studies. In the research cited below, the authors aimed to determine whether this effect persists longer than the follow-up period in previous studies.
Introduction
Prospective studies suggest that hypertension is a risk factor for developing dementia in later life − particularly vascular dementia and Alzheimer's disease. Targeting hypertension may thus be a promising strategy to delay or prevent dementia, given the high prevalence of high blood pressure and the good global availability of antihypertensives.
The Angiotensin Hypothesis
The specific mechanisms of action of various classes of antihypertensives may reflect their different influences on the risk of dementia, potentially explaining the inconsistent results of previous studies and meta-analyses. A network meta-analysis of studies comparing dementia risks among users of different classes of antihypertensives suggested that patients using ARBs and CCBs had a 12–17% lower risk of dementia than those treated with angiotensin-converting enzyme inhibitors (ACEIs) and beta-blockers (BBs), though this risk reduction was less compared to diuretics.
The potential mechanism explaining these findings is referred to as the
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