ArticlePloS one2018
The association of multiple anti-hypertensive medication classes with Alzheimer's disease incidence across sex, race, and ethnicity.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 2 syntheses or guidelines pooled it, 88 citations in OpenAlex.
- Comparative effects of angiotensin II stimulating and inhibiting antihypertensives on dementia risk: a systematic review and meta-analysis.GeroScience · 2025Pooled it
- Blood-Brain Barrier Crossing Renin-Angiotensin Drugs and Cognition in the Elderly: A Meta-Analysis.Hypertension (Dallas, Tex. : 1979) · 2021Pooled it
- Association of Angiotensin II-Stimulating Antihypertensive Use and Dementia Risk: Post Hoc Analysis of the PreDIVA Trial.Neurology · 2021Trial
- Rising Comorbid Alzheimer's and Hypertension Mortality in Older Adults in the United States: Trends and Disparities From a 21-Year CDC WONDER Analysis (1999-2019).Journal of clinical hypertension (Greenwich, Conn.) · 2026Article
- Article
- Virtual screening of drugs against multiple targets of Alzheimer's disease.Journal of Alzheimer's disease : JAD · 2025Article
- A comparison of drugs targeting the renin-angiotensin system and global cognition in aging.Journal of Alzheimer's disease : JAD · 2025Article
- Boosting angiotensin-converting enzyme (ACE) in microglia protects against Alzheimer's disease in 5xFAD mice.Nature aging · 2025Article
- Integrating Misclassified EHR Outcomes With Validated Outcomes From a Non-Probability Sample.Statistics in medicine · 2025Article
- The Use of Antihypertensive Medication and In Vivo Alzheimer's Disease Pathology.Annals of neurology · 2025Article
- Racial/Ethnic Disparities in Use of Angiotensin II Receptor Type 2/4 Stimulatory Vs. Inhibitory Antihypertensive Among Hypertensive Adults in the USA.Journal of racial and ethnic health disparities · 2025Article
- Antihypertensive drug classes and risk of incident dementia: a multinational population-based cohort study.Age and ageing · 2025Article
- The central renin-angiotensin system: A genetic pathway, functional decoding, and selective target engagement characterization in humans.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Exposure to angiotensin-converting enzyme inhibitors that cross the blood-brain barrier and the risk of dementia among patients with human immunodeficiency virus.medRxiv : the preprint server for health sciences · 2024Article
- Angiotensin Receptor Blockers and Cognition: a Scoping Review.Current hypertension reports · 2024Article
- Environmental, Sociocultural, Behavioral, and Biological Factors Associated with Cognitive Decline, Alzheimer's Disease, and Other Types of Dementia in Black Americans.Current epidemiology reports · 2023Article
- Sex Differences in the Preventive Effect of Cardiovascular and Metabolic Therapeutics on Dementia.Biomolecules & therapeutics · 2023Review
- Soluble and insoluble protein aggregates, endoplasmic reticulum stress, and vascular dysfunction in Alzheimer's disease and cardiovascular diseases.GeroScience · 2023Review
- The effect of race and co-morbidities on Alzheimer's disease based on Medicare data.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023Article
- The effect of novel antihypertensive drug valsartan on lysozyme aggregation: A combined in situ and in silico study.Heliyon · 2023Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundAntihypertensive treatments have been shown to reduce the risk of Alzheimer's disease (AD). The renin-angiotensin system (RAS) has been implicated in AD, and thus RAS-acting AHTs (angiotensin converting enzyme inhibitors (ACEIs), and angiotensin-II receptor blockers (ARBs)) may offer differential and additional protective benefits against AD compared with other AHTs, in addition to hypertension management.
methodsIn a retrospective cohort design, we examined the medical and pharmacy claims of a 20% sample of Medicare beneficiaries from 2007 to 2013, and compared rates of AD diagnosis for 1,343,334 users of six different AHT drug treatments, 65 years of age or older (4,215,338 person-years). We compared AD risk between RAS and non-RAS AHT drug users, and between ACEI users and ARB users, by sex and race/ethnicity. Models adjusted for age, socioeconomic status, underlying health, and comorbidities.
findingsRAS-acting AHTs were slightly more protective against onset of AD than non-RAS-acting AHTs for males, (male OR = 0.931 (CI: 0.895-0.969)), but not so for females (female OR = 0.985 (CI: 0.963-1.007)). Relative to other AHTs, ARBs were superior to ACEIs for both men (male ARB OR = 0.834 (CI: 0.788-0.884); male ACEI OR = 0.978 (CI: 0.939-1.019)) and women (female ARB OR = 0.941 (CI: 0.913-0.969); female ACEI OR = 1.022 (CI: 0.997-1.048)), but only in white men and white and black women. No association was shown for Hispanic men and women.
conclusionHypertension management treatments that include RAS-acting ARBs may, in addition to lowering blood pressure, reduce AD risk, particularly for white and black women and white men. Additional studies and clinical trials that include men and women from different racial and ethnic groups are needed to confirm these findings. Understanding the potentially beneficial effects of certain RAS-acting AHTs in high-risk populations is of great importance.
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