Scoping Review on the Long-Term Usage of Amlodipine and its Impact on Dementia Risk

Background: Hypertension is a known risk factor for dementia, particularly vascular dementia and Alzheimer’s. To achieve the target blood pressure, hypertensive patients require long-term treatment with antihypertensive medications. The most widely used type of dihydropyridine calcium channel blockers (CCBs) in Indonesia is amlodipine. Objective: This review aims to summarize existing evidence on the long-term use of amlodipine and its association with a decreased risk of dementia. Methods: Articles were gathered through searches on Pubmed, Sciencedirect, Spingerlink, Portal Garuda, and Google Scholar, covering the period from 2011 to 2021. Both Indonesian and English keywords were employed, and the article selection process adhered to PRISMA-ScR guidelines. Results: Over a decade, four systematic reviews (including two meta-analyses) and thirteen original articles investigated the impact of long-term CCB usage on dementia risk. The analysis involved a total of 714,047 hypertensive patients across 13 original articles. Of these, 46.1% were from European countries, 30.7% from America, and 23% from Asia. The most-referenced article, an RCT study involving 3,417 participants, was cited 201 times. Among CCB studies, one reported a significant reduction in dementia risk associated with long-term amlodipine use (at least 2.5 years). Conclusion: Numerous studies highlight the potential of long-term CCB use, particularly dihydropyridines, in lowering the risk of dementia. However, research specifically on amlodipine remains limited. Considering the widespread use of amlodipine in Indonesia, further investigation is crucial to elucidate its impact on reducing the risk of dementia.