Table 4.

Main Longitudinal Studies on the Relationship Between Use of Antihypertensive Drugs and Risk of Dementia

Author, Year of PublicationStudySample SizeType of SampleAge Criteria, yMean Age, yFollow-Up, yDiagnosis of DementiaEffect of Antihypertensive Drug Overall (95% CI)Effect by Type of Antihypertensive Drug (95% CI)
Guo et al,435 1999Kungsholmen project1301Community based; no dementia≥75833Dementia, Alzheimer disease: DSM-III-RDementia: RR=0.7 (0.6–1.0)Treatment effect mainly because of diuretics
in't Veld et al,432 2001Rotterdam study6416Community based; no dementia≥55682.2Dementia: DSM-III-R; Alzheimer disease: NINCDS-ADRDA; VaD: NINDS-AIRENDementia overall: RR=0.76 (0.52–1.12); VaD: RR=0.33 (0.11–0.99); Alzheimer disease: RR=0.87 (0.56–1.37)No differences among antihypertensive drugs
Morris et al,434 2001EPESE634Random sample≥65724Alzheimer disease: NINCDS-ADRDAAlzheimer disease: RR=0.66 (0.68–2.61)No differences among antihypertensive drugs
Lindsay et al,433 2002Canadian Study of Health and Aging4088National sample≥65735Alzheimer disease: DSM-IVAlzheimer disease: RR=0.91 (0.64–1.30)
Qiu et al,437 2003Kungsholmen project1270Community based; no dementia≥75815Dementia, Alzheimer disease: DSM-III-RDementia: RR=0.8 (0.6–1.0); Alzheimer disease: RR=0.7 (0.5–0.9)
Yasar et al,430 2005Baltimore Longitudinal Study of Aging1092Community based; no dementia≥607819Dementia: DSM-III-R; Alzheimer disease: NINCDS-ADRDAAlzheimer disease: RR=0.30 (0.07–1.25) for dihydropyridine type of CCB; RR=0.82 (0.37–1.83) for nondihydropyridine type of CCB
Khachaturian et al,436 2006Cache County Study3297Community based; no dementia≥65743Dementia: DSM-III-R; Alzheimer disease: NINCDS-ADRDAAlzheimer disease: RR=0.64 (0.41–0.98)Stronger effect for diuretics and specifically potassium-sparing diuretics, HR=0.26 (0.08–0.64)
Peila et al,431 2006Honolulu-Asia Aging Study1294Community-based cohort≥72765Dementia: DSM-III R and DSM-IV; Alzheimer disease: NINCDS-ADRDA; VaD: CADDTCHR per year of antihypertensive use: Dementia: HR=0.94 (0.89–0.99); Alzheimer disease: HR=0.96 (0.93–0.99); VaD: HR=0.94 (0.89–0.99)
Haag et al,429 2009Rotterdam study6249Community based; no dementia≥556813Dementia: DSM-III-R; Alzheimer disease: NINCDS-ADRDA; VaD: NINDS-AIRENHR per year of antihypertensive use: Dementia: HR=0.95 (0.91–0.99); Alzheimer disease: HR=0.94 (0.90–0.99)No differences among antihypertensive drugs
Li et al,438 2009US Veterans Affairs819 491Administrative database≥65744No specified criteriaHR for dementia: ARB vs cardiovascular drugs HR=0.76 (0.69–0.84); ARB vs lisinopril HR=0.81 (0.73–0.90); lisinopril vs cardiovascular drugs HR=0.94 (0.91–0.97)
  • CI indicates confidence interval; DSM-III-R, Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (revised); RR, relative risk; NINCDS-ADRDA, National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer's Disease and Related Disorders Association; VaD, vascular dementia; NINDS-AIREN, National Institute of Neurological Disorders and Stroke–Association Internationale pour la Recherche et l'Enseignement en Neurosciences; EPESE, East Boston Established Populations for Epidemiologic Studies of the Elderly; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, 4th edition; CCB, calcium channel blocker; HR, hazard ratio; CADDTC, California Alzheimer's Disease Diagnostic and Treatment Centers; and ARB, angiotensin II receptor blocker.