Pharmacological treatment of hypertension in older adults decreased cognitive decline compared to placebo (SMD -0.049; 95% CI -0.078 to -0.019).
Meta-Analysis (n=34,994)
Does pharmacological treatment of hypertension reduce cognitive decline in older adults?
Pharmacological treatment of hypertension in older adults is associated with a significant reduction in cognitive decline, which has important implications for dementia prevention.
Effect estimate: SMD -0.049 (95% CI -0.078 to -0.019)
Objectives To systematically analyse the effect of pharmacological treatment of hypertension (HTN) on cognitive decline in older adults. Methods Randomised, placebo-controlled trials with a prespecified quantitative outcome of cognition and a pharmacological intervention for at least 12 months to treat HTN in older adults (>60 years). Our primary outcome was change in cognition with pharmacological treatment of HTN. Standardised mean difference (SMD) was used to analyse different outcomes reported in the selected studies. We searched PubMed CENTRAL and the Cochrane Library from inception to 6 July 2020. Two independent reviewers assessed trial quality and extracted data. Internal and external validity of the studies was assessed. Results Nine randomised controlled trials with 34 994 participants were included in the final analysis. The net SMD for change in cognition was −0.049 (CI: −0.078 to −0.019) indicating that treatment of HTN decreased cognitive decline. Heterogeneity was low with an I² of 6%. Discussion Current evidence does not indicate worsening of cognition with treatment of HTN. Treatment of HTN in older adults may reduce cognitive decline. These results have important implications in clinical management of patients at risk for dementia. PROSPERO registration number CRD42020139750.
Gupta et al. (2020) conducted a meta-analysis in Hypertension (n=34,994). Pharmacological treatment of hypertension vs. Placebo was evaluated on change in cognition (SMD -0.049, 95% CI -0.078 to -0.019). Pharmacological treatment of hypertension in older adults decreased cognitive decline compared to placebo (SMD -0.049; 95% CI -0.078 to -0.019).