Do Patient Concerns About Antihypertensive Use For Dementia Prevention Vary By Current Use Of Antihypertensive?

Antihypertensives may have effects on the brain beyond blood pressure lowering. Ongoing clinical trials aim to evaluate the effectiveness of approved antihypertensives in preventing dementia, including patients with and without hypertension. In order for a dementia prevention strategy using antihypertensives to be effective, it is critical to understand patient concerns about this strategy in both users and non-users of antihypertensives. Thus, this study examined the association between current use of antihypertensive and having concerns about using an antihypertensive as a dementia prevention strategy, as well as sociodemographic factors associated with concerns. Cross-sectional,  self-administered, web-based survey was conducted among 1661 patients in a large health system in January 2018. Participants reported whether they were currently taking an antihypertensive (yes/no), and what types of hypothetical concerns they have about the idea of taking an antihypertensive to prevent dementia (yes/no, for each of 7 concerns). Associations between the two variables were assessed via logistic regression, and odds ratios with 95% confidence intervals were calculated. Most respondents were female (77%), 51-70 years of age (64%), and white (89%), with 30% reporting current antihypertensive use. Compared to current users, non-users were more likely to report the five following concerns: side effects from the medication, hassle to take medications, lack of evidence, not wanting to use medications, and already having normal/low blood pressure. Non-users were also less likely to report having no concerns (adjusted OR = 0.3; 95% CI = 0.2-0.4) compared to current users. Younger age and lower income were associated with having more concerns. Patients not currently using an antihypertensive are more likely to have concerns about using an antihypertensive for dementia prevention, compared to current antihypertensive users. Patient perspectives are important to consider for the implementation of dementia prevention strategies.

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© 2019 Lee et al.

Déclaration de conflit d'intérêts

Dr Doug Barthold reports personal fees from Omada Health for serving as an analysis consultant for a scientific analysis of Omada’s digital diabetes app., outside the submitted work. Dr Paul K Crane reports grant from Eisai for consulting and travel fees for lecturing at Eisai on cognitively defined Alzheimer’s disease subtypes in 2018, outside the submitted work. The authors report no other conflicts of interest in this work.