dc.creator | Liampas I., Hatzimanolis A., Siokas V., Yannakoulia M., Kosmidis M.H., Sakka P., Hadjigeorgiou G.M., Scarmeas N., Dardiotis E. | en |
dc.date.accessioned | 2023-01-31T08:50:34Z | |
dc.date.available | 2023-01-31T08:50:34Z | |
dc.date.issued | 2022 | |
dc.identifier | 10.3233/JAD-220439 | |
dc.identifier.issn | 13872877 | |
dc.identifier.uri | http://hdl.handle.net/11615/75830 | |
dc.description.abstract | Background: It is unclear whether the main antihypertensive medication classes (diuretics, calcium channel blockers, beta-blockers, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers (ARBs)) are associated with different risks of cognitive decline. Published evidence is conflicting and stems mainly from observational studies. Objective: To investigate the differential effects of antihypertensives on the risks of developing dementia and cognitive decline, with a specific focus on the vascular component of the mechanisms underlying these interactions. Methods: Older adults with a history of hypertension and without dementia were drawn from the population-based HELIAD cohort. Age-, gender-, education-, and antihypertensive medication-(five dichotomous exposures) adjusted Cox proportional-hazards models and generalized estimating equations were performed to appraise the associations of baseline antihypertensive therapy with dementia incidence and cognitive decline (quantified using a comprehensive neuropsychological battery). Analyses were subsequently adjusted for clinical vascular risk (dyslipidemia, diabetes mellitus, smoking, cardiovascular, and cerebrovascular history) and genetic susceptibility to stroke (using polygenic risk scores generated according to the MEGASTROKE consortium GWAS findings). Results: A total of 776 predominantly female participants (73.61±4.94 years) with hypertension and a mean follow-up of 3.02±0.82 years were analyzed. Baseline treatment was not associated with the risk of incident dementia. ARB users experienced a slower yearly global cognitive [2.5% of a SD, 95% CI = (0.1, 4.9)] and language [4.4% of a SD, 95% CI = (1.4, 7.4)] decline compared to non-users. The fully adjusted model reproduced similar associations for both global cognitive [β= 0.027, 95% CI = (-0.003, 0.057)], and language decline [β= 0.063, 95% CI = (0.023, 0.104)]. Conclusion: ARBs may be superior to other antihypertensive agents in the preservation of cognition, an association probably mediated by vascular-independent mechanisms. © 2022-IOS Press. All rights reserved. | en |
dc.language.iso | en | en |
dc.source | Journal of Alzheimer's Disease | en |
dc.source.uri | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85138450717&doi=10.3233%2fJAD-220439&partnerID=40&md5=ac1d217e7f2c2cc9fc70ff52cf95befc | |
dc.subject | angiotensin receptor antagonist | en |
dc.subject | antihypertensive agent | en |
dc.subject | beta adrenergic receptor blocking agent | en |
dc.subject | calcium channel blocking agent | en |
dc.subject | dipeptidyl carboxypeptidase inhibitor | en |
dc.subject | diuretic agent | en |
dc.subject | angiotensin receptor antagonist | en |
dc.subject | antihypertensive agent | en |
dc.subject | calcium channel blocking agent | en |
dc.subject | dipeptidyl carboxypeptidase inhibitor | en |
dc.subject | diuretic agent | en |
dc.subject | aged | en |
dc.subject | allele | en |
dc.subject | antihypertensive therapy | en |
dc.subject | Article | en |
dc.subject | attention | en |
dc.subject | cardiovascular disease | en |
dc.subject | cerebrovascular accident | en |
dc.subject | cerebrovascular disease | en |
dc.subject | cognition | en |
dc.subject | cognitive defect | en |
dc.subject | cohort analysis | en |
dc.subject | controlled study | en |
dc.subject | dementia | en |
dc.subject | depth perception | en |
dc.subject | diabetes mellitus | en |
dc.subject | dyslipidemia | en |
dc.subject | educational status | en |
dc.subject | executive function | en |
dc.subject | female | en |
dc.subject | follow up | en |
dc.subject | genetic risk score | en |
dc.subject | genetic susceptibility | en |
dc.subject | genotyping | en |
dc.subject | human | en |
dc.subject | hypertension | en |
dc.subject | language | en |
dc.subject | language disability | en |
dc.subject | major clinical study | en |
dc.subject | male | en |
dc.subject | memory | en |
dc.subject | neuropsychological test | en |
dc.subject | smoking | en |
dc.subject | cognitive defect | en |
dc.subject | complication | en |
dc.subject | dementia | en |
dc.subject | hypertension | en |
dc.subject | prospective study | en |
dc.subject | Aged | en |
dc.subject | Angiotensin Receptor Antagonists | en |
dc.subject | Angiotensin-Converting Enzyme Inhibitors | en |
dc.subject | Antihypertensive Agents | en |
dc.subject | Calcium Channel Blockers | en |
dc.subject | Cognitive Dysfunction | en |
dc.subject | Dementia | en |
dc.subject | Diuretics | en |
dc.subject | Female | en |
dc.subject | Humans | en |
dc.subject | Hypertension | en |
dc.subject | Male | en |
dc.subject | Prospective Studies | en |
dc.subject | IOS Press BV | en |
dc.title | Antihypertensive Medication Class and the Risk of Dementia and Cognitive Decline in Older Adults: A Secondary Analysis of the Prospective HELIAD Cohort | en |
dc.type | journalArticle | en |