ArticleEpidemiology (Cambridge, Mass.)2020
Comparison of Antihypertensive Drug Classes for Dementia Prevention.
Article in Epidemiology (Cambridge, Mass.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 4 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.
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Who cites it
16 citing papers in PubMed, 4 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- A systematic review of risk factors for vascular dementia using Mendelian randomization: a call for methodologically robust studies to advance knowledge.BMC neurology · 2026Pooled it
- Use of sensitivity analyses to assess uncontrolled confounding from unmeasured variables in observational, active comparator pharmacoepidemiologic studies: a systematic review.American journal of epidemiology · 2025Pooled it
- Pooled it
- Systematically exploring repurposing effects of antihypertensives.Pharmacoepidemiology and drug safety · 2022Pooled it
- Delirium in Patients With Traumatic Brain Injury and Long-Term Cognitive Decline: A Global Federated Real World Data Analysis.European journal of clinical investigation · 2026Article
- Class-Specific Antihypertensives and Alzheimer's Disease: Genotype- and Hypertension-Stratified Analysis.Molecular neurobiology · 2026Article
- Hypertension as a Major Risk Factor in Alzheimer's Disease: Mechanisms, Interactions and Therapeutic Perspectives.Clinical interventions in aging · 2026Review
- 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
- Deciphering the Role of Adrenergic Receptors in Alzheimer's Disease: Paving the Way for Innovative Therapies.Biomolecules · 2025Review
- Association of Hypertension with Different Cognitive Disorders.Journal of clinical medicine · 2024Review
- Blood-brain barrier permeable β-blockers linked to lower risk of Alzheimer's disease in hypertension.Brain : a journal of neurology · 2023Article
- Association between use of antihypertensives and cognitive decline in the elderly-A retrospective observational study.PloS one · 2023Observational
- Neuroprotective effect of angiotensin II receptor blockers on the risk of incident Alzheimer's disease: A nationwide population-based cohort study.Frontiers in aging neuroscience · 2023Article
- Pharmacoepidemiology in pregnancy: analysis protocol for an observational cohort study in the UK Clinical Practice Research Datalink.Wellcome open research · 2022Article
- Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 3 countries.
Funding
Abstract
backgroundHypertension in midlife is associated with increased risk of Alzheimer disease and vascular dementia late in life. In addition, some antihypertensive drugs have been proposed to have cognitive benefits, independent of their effect on hypertension. Consequently, there is potential to repurpose antihypertensive drugs for the prevention of dementia. This study systematically compared seven antihypertensive drug classes for this purpose, using the Clinical Practice Research Datalink.
methodsWe assessed treatments for hypertension in an instrumental variable analysis to address potential confounding and reverse causation. We used physicians' prescribing preference as an ordinal instrument, defined by the physicians' last seven prescriptions. Participants considered were new antihypertensive users between 1996 and 2016, aged 40 and over.
resultsWe analyzed 849,378 patients, with total follow up of 5,497,266 patient-years. We estimated that β-adrenoceptor blockers and vasodilator antihypertensives conferred small protective effects-for example, β-adrenoceptor blockers were associated with 13 (95% confidence interval = 6, 20) fewer cases of any dementia per 1000 treated compared with other antihypertensives.
conclusionsWe estimated small differences in the effects of antihypertensive drug classes on dementia outcomes. We also show that the magnitude of the differences between drug classes is smaller than that previously reported. Future research should look to implement other causal analysis methods to address biases in conventional observational research, with the ultimate aim of triangulating the evidence concerning this hypothesis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.