ArticleThe journal of prevention of Alzheimer's disease2024
Anti-Hypertensives Reduce the Rate of Alzheimer's Disease Progression: A Cohort Study Linked with Genetic and Neuropathological Analyses.
Article in The journal of prevention of Alzheimer's disease, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Clinical outcomes of antihypertensive medication use in people with dementia: a systematic review and meta-analysis.GeroScience · 2026Pooled it
- Ang II-mediated effects on BBB integrity in psychiatric and neurological disorders.Progress in neuro-psychopharmacology & biological psychiatry · 2026Review
- Angiotensin II-Stimulating Antihypertensive Medications and Dementia-Related Neuropathology.JAMA network open · 2026Article
- Association between angiotensin receptor blocker use and postmortem dementia pathology: analysis of the UK Brain Banks Network dataset.BMJ neurology open · 2026Article
- Blood pressure and Alzheimer's disease biomarkers in cognitively unimpaired adults: a multicenter study.The journal of prevention of Alzheimer's disease · 2025Observational
- Medical Comorbidities in Alzheimer's Disease: An Autopsy Confirmed Study with a Focus on Sex-Differences?Clinical neuropsychiatry · 2025Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundArterial hypertension contributes to both the development and progression of dementia due to both Alzheimer's disease (A.D.) and vascular pathology. However, the effects of different classes of anti-hypertensives (A.H.T.s), on the rate of dementia progression and brain neuropathology are unknown.
objectiveTo investigate the effect of each class of A.H.T., both as single and combined, on the rate of dementia progression. In addition, we analyzed the effect of A.H.T.s on brain neuropathology in AD participants, indicated by Braak staging, hippocampal atrophy, and baseline CSF levels of A-β42, total (T) tau, and P-181 tau.
methodsWe have used the National Alzheimer's Coordinating Center (NACC) Uniform Data Set (UDS).
resultsA.H.T.s were associated with reduced yearly increase in the CDR-SOB scores of 1.025 during a 10-year follow-up (P<0.001). The overall survival rate was higher in A.H.T. users than non-users [HR: 0.912: 0.860, 0.967) P=0.002]. These trends continued when stratifying participants by age, gender, and APOE4 allele. Participants who did not use A.H.T.s had a mean yearly increase of 1.71±1.7 in the CDR-SOB scores. This value was reduced to 1.48±1.6, P=0.006 and 1.45±1.6, P=0.024 for participants with documented use of βB and A.R.B.s, respectively. Combining diuretics with α1-AB or ACEI led to synergistic effects in reducing the rise in CDR-SOB scores. The proportion of participants who were diagnosed having AD postmortem with severe Braak staging was significantly lower in A.H.T.-users than non-users. The severity of Braak staging, and hippocampal atrophy differed in participants> 70 vs. <70 years old, in both males and females. A significant relationship was observed between hippocampal atrophy and Braak staging; and between hippocampal atrophy and baseline CSF levels of P-181 tau.
conclusionOur results could have implications for halting the progression of dementia regardless of the etiology being related to AD or vascular pathology. The choice of combination of A.H.T. therapy should also consider the combination which would lead to an optimum benefit in slowing the progression of dementia. Additionally, our results underline a more complex A.D. disease model than previously thought, which opens new treatment options.
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