Table 6.

Main Randomized Trials of Antihypertensive Drugs That Have Included Cognitive Impairment or Dementia as Outcomes: Results on Dementia

StudyDiagnosis of DementiaIncidence and Number of Dementia CasesMain Results on Dementia (95% CI)Type of Dementia (Alzheimer Disease vs VCI or Poststroke Dementia)
ActivePlacebo
Cases of Dementia/Number of patientsIncidence (per 1000 patient-years)Cases of Dementia/Number of PatientsIncidence (per 1000 patient-years)
SHEP440Expert-based; DSM-III-R37/2365Not indicated44/2371Not indicated16% Reduction in dementia; nonsignificantNot defined
Syst-Eur442Expert-based; DSM-III-R11/12383.821/11807.750% (0% to 76%) Reduction in dementia; P=0.0523 Cases of Alzheimer disease and 7 cases of mixed dementia
PROGRESS445Expert-based; DSM-IV193/305116217/30541912% (−8% to 28%) Reduction in dementia; P=0.234% (3% to 55%) Reduction in dementia with recurrent stroke; P=0.03 1% (−24% to 22%) for other dementia; P=0.9
SCOPE443ICD-10 criteria; Independent Clinical Event Committee62/24776.857/24606.37% Increased risk in active arm; P>0.20Not defined
HYVET444Expert based; DSM-IV126/168733137/16493814% (−9% to 23%) Reduction in dementia; P=0.2Similar results for Alzheimer disease (164 patients) and vascular dementia (84 patients)
PRoFESS441Clinical impression of dementia408/8624Not indicated409/8646Not indicatedNo reduction of the risk of dementia; P=0.48Not defined
  • CI indicates confidence interval; VCI, vascular cognitive impairment; SHEP, Systolic Hypertension in the Elderly Program; DSM-III-R, Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (revised); Syst-Eur, Systolic Hypertension in Europe; PROGRESS, Perindopril Protection Against Recurrent Stroke Study; DSM-IV, Diagnostic and StatisticalManual of Mental Disorders, 4th edition; SCOPE, Study on Cognition and Prognosis in the Elderly; ICD-10, International Classification of Disease, 10th edition; HYVET, Hypertension in the Very Elderly Trial; and PRoFESS, Prevention Regimen for Effectively Avoiding Second Strokes.