Does the use of Ang-II stimulating antihypertensive medications reduce the risk of developing dementia in patients with hypertension compared to Ang-II inhibiting antihypertensive medications?
In patients with hypertension, the use of angiotensin II-stimulating antihypertensives is associated with an 18% lower risk of developing dementia compared to angiotensin II-inhibiting antihypertensives.
Midlife hypertension is a modifiable risk factor for dementia. The effects of angiotensin II (Ang-II) stimulating versus inhibiting antihypertensive medications (AHMs) on the risk of developing dementia remain unclear. This nested case-control study compared the association between treatment with Ang-II stimulating versus inhibiting AHMs and dementia risk using an Australian general practice dataset, MedicineInsight among 25,134 matched participants. We included 25,134 participants aged ≥ 45 years (6303 cases and 18,831 matched controls) with hypertension and at least one year of AHM therapy between January 1, 2011, and December 31, 2020. Exposure was classified using the proportion of days covered into high (≥ 80%) and lower (interaction = 0.019), prevalent AHM users (initiated before January 1, 2011; pinteraction interaction interaction = 0.085) and mean systolic (pinteraction = 0.063) or diastolic (pinteraction = 0.334) blood pressure during follow-up. The findings support the potential role of Ang-II stimulating AHMs (e.g., ARBs thiazides, DHP CCBs), relative to Ang-II inhibiting AHMs (e.g., ACEIs BBs, non-DHP CCBs), in reducing the risk of dementia in people with hypertension.
Belachew et al. (Mon,) studied this question.