Association of Angiotensin II-Stimulating Antihypertensive Use and Dementia Risk: Post Hoc Analysis of the PreDIVA Trial.

Aged Angiotensin II / drug effects Angiotensin-Converting Enzyme Inhibitors / therapeutic use Antihypertensive Agents / therapeutic use Dementia / epidemiology Female Humans Hypertension / drug therapy Incidence Male Sodium Chloride Symporter Inhibitors / therapeutic use

Journal

Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060

Informations de publication

Date de publication:
05 01 2021
Historique:
received: 18 02 2020
accepted: 12 08 2020
pubmed: 7 11 2020
medline: 16 1 2021
entrez: 6 11 2020
Statut: ppublish

Résumé

To assess whether angiotensin II-stimulating antihypertensives (thiazides, dihydropyridine calcium channel blockers, and angiotensin I receptor blockers) convey a lower risk of incident dementia compared to angiotensin II-inhibiting antihypertensives (angiotensin-converting enzyme inhibitors, β-blockers, and nondihydropyridine calcium channel blockers), in accordance with the "angiotensin hypothesis." We performed Cox regression analyses of incident dementia (or mortality as competing risk) during 6-8 years of follow-up in a population sample of 1,909 community-dwelling individuals (54% women) without dementia, aged 70-78 (mean 74.5 ± 2.5) years. After a median of 6.7 years of follow-up, dementia status was available for 1,870 (98%) and mortality for 1,904 (>99%) participants. Dementia incidence was 5.6% (27/480) in angiotensin II-stimulating, 8.2% (59/721) in angiotensin II-inhibiting, and 6.9% (46/669) in both antihypertensive type users. Adjusted for dementia risk factors including blood pressure and medical history, angiotensin II-stimulating antihypertensive users had a 45% lower incident dementia rate (hazard ratio [HR], 0.55; 95% CI, 0.34-0.89) without excess mortality (HR, 0.86; 95% CI, 0.64-1.16), and individuals using both types had a nonsignificant 20% lower dementia rate (HR, 0.80; 95% CI,0.53-1.20) without excess mortality (HR, 0.97; 95% CI, 0.76-1.24), compared to angiotensin II-inhibiting antihypertensive users. Results were consistent for subgroups based on diabetes and stroke history, but may be specific for individuals without a history of cardiovascular disease. Users of angiotensin II-stimulating antihypertensives had lower dementia rates compared to angiotensin II-inhibiting antihypertensive users, supporting the angiotensin hypothesis. Confounding by indication must be examined further, although subanalyses suggest this did not influence results. If replicated, dementia prevention could become a compelling indication for older individuals receiving antihypertensive treatment.

Identifiants

DOI: 10.1212/WNL.0000000000010996 PMID: 33154085 PMC: PMC7884979
pubmed: 33154085
pii: WNL.0000000000010996
doi: 10.1212/WNL.0000000000010996
pmc: PMC7884979
doi:

Substances chimiques

Angiotensin-Converting Enzyme Inhibitors 0
Antihypertensive Agents 0
Sodium Chloride Symporter Inhibitors 0
Angiotensin II 11128-99-7

Banques de données

ISRCTN
['ISRCTN29711771']

Types de publication

Journal Article Randomized Controlled Trial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

e67-e80

Subventions

Organisme : AHRQ HHS
ID : K12 HS022982
Pays : United States
Organisme : NIA NIH HHS
ID : K76 AG059929
Pays : United States

Informations de copyright

Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

Références

J Hypertens. 2017 Sep;35(9):1881-1890
pubmed: 28441185
Pharmacol Res. 2017 Nov;125(Pt A):39-47
pubmed: 28694144
Neurosci Biobehav Rev. 2018 Sep;92:209-225
pubmed: 29733881
Front Aging Neurosci. 2018 Dec 18;10:418
pubmed: 30618724
Cell Mol Neurobiol. 2016 Mar;36(2):219-32
pubmed: 26993506
Circ J. 2016 Oct 25;80(11):2336-2342
pubmed: 27666598
JAMA. 2019 Feb 12;321(6):602-603
pubmed: 30676631
Neurology. 2016 Aug 9;87(6):601-8
pubmed: 27402894
J Neurol Sci. 2012 Nov 15;322(1-2):64-70
pubmed: 22818266
Neurosci Lett. 2016 Jun 15;624:53-61
pubmed: 27163195
Lancet. 2016 Aug 20;388(10046):797-805
pubmed: 27474376
JAMA. 2019 Feb 12;321(6):553-561
pubmed: 30688979
Curr Hypertens Rep. 2016 Aug;18(8):66
pubmed: 27492369
J Am Med Dir Assoc. 2018 Jul;19(7):577-583
pubmed: 29306604
J Hypertens. 2016 Jun;34(6):1027-35
pubmed: 26886565
Am J Cardiol. 1985 Dec 6;56(16):62H-67H
pubmed: 2933950
Epidemiology. 2018 Sep;29(5):e45-e47
pubmed: 29912013
Curr Hypertens Rep. 2017 Mar;19(3):24
pubmed: 28299725
Hypertension. 2012 Aug;60(2):260-8
pubmed: 22753214
Neurology. 2013 Sep 3;81(10):888-95
pubmed: 23911753
PLoS One. 2018 Nov 1;13(11):e0206705
pubmed: 30383807
J Alzheimers Dis. 2019;68(4):1479-1488
pubmed: 30909218
J Hypertens. 2017 Oct;35(10):2095-2101
pubmed: 28509727
Eur J Prev Cardiol. 2012 Dec;19(6):1365-72
pubmed: 21930719
Neurology. 2013 Sep 3;81(10):896-903
pubmed: 23911756
Br J Pharmacol. 2011 Jul;163(6):1122-30
pubmed: 21175580
Arch Neurol. 2012 Dec;69(12):1632-8
pubmed: 22964777
Neurobiol Aging. 2010 Jan;31(1):1-7
pubmed: 18378359
Lancet. 2017 Dec 16;390(10113):2673-2734
pubmed: 28735855
J Hypertens. 2018 Sep;36(9):1780-1787
pubmed: 29927845
Lancet Neurol. 2014 Aug;13(8):788-94
pubmed: 25030513
BMJ. 2014 Aug 21;349:g5060
pubmed: 25146097
Curr Alzheimer Res. 2015;12(1):32-46
pubmed: 25523424
N Engl J Med. 2017 Nov 16;377(20):1964-1975
pubmed: 29141174
J Alzheimers Dis. 2018;62(3):1443-1466
pubmed: 29562545
J Alzheimers Dis. 2019;68(2):523-529
pubmed: 30814348
Heart. 2007 Sep;93(9):1026-33
pubmed: 17488768
J Am Coll Cardiol. 2018 May 15;71(19):e127-e248
pubmed: 29146535
Cell Mol Neurobiol. 2006 Oct-Nov;26(7-8):1099-111
pubmed: 16636899
Am J Hypertens. 2015 Jun;28(6):717-21
pubmed: 25344354
Curr Hypertens Rep. 2016 Aug;18(8):67
pubmed: 27492370
J Gen Intern Med. 2018 Apr;33(4):455-462
pubmed: 29330643
Expert Rev Cardiovasc Ther. 2010 Jun;8(6):793-802
pubmed: 20528637
Physiol Rev. 2018 Jul 1;98(3):1627-1738
pubmed: 29873596
Neurosci Lett. 2018 Apr 3;671:120-127
pubmed: 29452176
Int J Cardiol. 2016 Oct 1;220:668-76
pubmed: 27393848
Circulation. 2011 Apr 19;123(15):1611-21
pubmed: 21464050
J Intern Med. 2018 Dec;284(6):620-642
pubmed: 30264910

Auteurs

Jan Willem van Dalen (JW)

From the Departments of Neurology (J.W.v.D., W.A.v.G., E.R.) and General Practice (E.P.M.v.C.), Amsterdam UMC, University of Amsterdam; Department of Neurology (J.W.v.D., E.R.), Donders Institute for Brain, Behaviour and Cognition, Radboud University Medical Centre, Nijmegen, the Netherlands; Schools of Pharmacy (Z.A.M., S.L.G., D.B.) and Medicine (P.K.C.), University of Washington; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle. j.vandalen@amc.nl.
ORCID: 0000-0002-3439-8841

Zachary A Marcum (ZA)

From the Departments of Neurology (J.W.v.D., W.A.v.G., E.R.) and General Practice (E.P.M.v.C.), Amsterdam UMC, University of Amsterdam; Department of Neurology (J.W.v.D., E.R.), Donders Institute for Brain, Behaviour and Cognition, Radboud University Medical Centre, Nijmegen, the Netherlands; Schools of Pharmacy (Z.A.M., S.L.G., D.B.) and Medicine (P.K.C.), University of Washington; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle.

Shelly L Gray (SL)

From the Departments of Neurology (J.W.v.D., W.A.v.G., E.R.) and General Practice (E.P.M.v.C.), Amsterdam UMC, University of Amsterdam; Department of Neurology (J.W.v.D., E.R.), Donders Institute for Brain, Behaviour and Cognition, Radboud University Medical Centre, Nijmegen, the Netherlands; Schools of Pharmacy (Z.A.M., S.L.G., D.B.) and Medicine (P.K.C.), University of Washington; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle.

Douglas Barthold (D)

From the Departments of Neurology (J.W.v.D., W.A.v.G., E.R.) and General Practice (E.P.M.v.C.), Amsterdam UMC, University of Amsterdam; Department of Neurology (J.W.v.D., E.R.), Donders Institute for Brain, Behaviour and Cognition, Radboud University Medical Centre, Nijmegen, the Netherlands; Schools of Pharmacy (Z.A.M., S.L.G., D.B.) and Medicine (P.K.C.), University of Washington; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle.

Eric P Moll van Charante (EP)

From the Departments of Neurology (J.W.v.D., W.A.v.G., E.R.) and General Practice (E.P.M.v.C.), Amsterdam UMC, University of Amsterdam; Department of Neurology (J.W.v.D., E.R.), Donders Institute for Brain, Behaviour and Cognition, Radboud University Medical Centre, Nijmegen, the Netherlands; Schools of Pharmacy (Z.A.M., S.L.G., D.B.) and Medicine (P.K.C.), University of Washington; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle.

Willem A van Gool (WA)

From the Departments of Neurology (J.W.v.D., W.A.v.G., E.R.) and General Practice (E.P.M.v.C.), Amsterdam UMC, University of Amsterdam; Department of Neurology (J.W.v.D., E.R.), Donders Institute for Brain, Behaviour and Cognition, Radboud University Medical Centre, Nijmegen, the Netherlands; Schools of Pharmacy (Z.A.M., S.L.G., D.B.) and Medicine (P.K.C.), University of Washington; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle.

Paul K Crane (PK)

From the Departments of Neurology (J.W.v.D., W.A.v.G., E.R.) and General Practice (E.P.M.v.C.), Amsterdam UMC, University of Amsterdam; Department of Neurology (J.W.v.D., E.R.), Donders Institute for Brain, Behaviour and Cognition, Radboud University Medical Centre, Nijmegen, the Netherlands; Schools of Pharmacy (Z.A.M., S.L.G., D.B.) and Medicine (P.K.C.), University of Washington; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle.

Eric B Larson (EB)

From the Departments of Neurology (J.W.v.D., W.A.v.G., E.R.) and General Practice (E.P.M.v.C.), Amsterdam UMC, University of Amsterdam; Department of Neurology (J.W.v.D., E.R.), Donders Institute for Brain, Behaviour and Cognition, Radboud University Medical Centre, Nijmegen, the Netherlands; Schools of Pharmacy (Z.A.M., S.L.G., D.B.) and Medicine (P.K.C.), University of Washington; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle.

Edo Richard (E)

From the Departments of Neurology (J.W.v.D., W.A.v.G., E.R.) and General Practice (E.P.M.v.C.), Amsterdam UMC, University of Amsterdam; Department of Neurology (J.W.v.D., E.R.), Donders Institute for Brain, Behaviour and Cognition, Radboud University Medical Centre, Nijmegen, the Netherlands; Schools of Pharmacy (Z.A.M., S.L.G., D.B.) and Medicine (P.K.C.), University of Washington; and Kaiser Permanente Washington Health Research Institute (E.B.L.), Seattle.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Association of Angiotensin II-Stimulating...
questionsmedicales.fr › Facteurs biologiques › Médiateurs de l'inflammation › Autacoïdes › Angiotensines › Angiotensine-II › Association of Angiotensin II-Stimulating...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Mécanismes moléculaires de l'action pharmacologique › Antienzymes › Inhibiteurs de protéases › Inhibiteurs de l'enzyme de conversion de l'angiotensine › Association of Angiotensin II-Stimulating...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents cardiovasculaires › Antihypertenseurs › Association of Angiotensin II-Stimulating...
questionsmedicales.fr › Troubles mentaux › Troubles neurocognitifs › Démence › Association of Angiotensin II-Stimulating...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Association of Angiotensin II-Stimulating...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Hypertension artérielle › Association of Angiotensin II-Stimulating...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Registre civil › Morbidité › Incidence › Association of Angiotensin II-Stimulating...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Effets physiologiques des médicaments › Diurétiques › Inhibiteurs du symport chlorure sodium › Association of Angiotensin II-Stimulating...