Key result
All classes of antihypertensive medications showed similar patterns with most studies reporting point estimates below one for dementia risk, though few reached statistical significance for a specific class.
Why the study?
Do antihypertensive medications reduce cognitive decline or incident dementia in participants without existing cognitive impairment?
Do antihypertensive medications reduce cognitive decline or incident dementia in participants without existing cognitive impairment?
Current evidence suggests a potential protective effect of antihypertensive medications against cognitive decline and dementia, but methodological limitations and inconsistent findings across drug classes preclude definitive recommendations.
No class-specific dementia benefit seen among antihypertensives; extends evidence for modest risk reduction across agents but leaves definitive effect open.
PURPOSE OF REVIEW: There is an established association between hypertension and increased risk of poor cognitive performance and dementia including Alzheimer's disease; however, associations between antihypertensive medications (AHMs) and dementia risk are less consistent. An increased interest in AHM has resulted in expanding publications; however, none of the recent reviews are comprehensive. Our extensive review includes 15 observational and randomized controlled trials (RCTs) published over the last 5 years, assessing the relationship between AHM and cognitive impairment. RECENT FINDINGS: All classes of AHM showed similar result patterns in human studies with the majority of study results reporting point estimates below one and only a small number of studies (N = 15) reporting statistically significant results in favor of a specific class. Only a small number of studies reported statistically significant results in favor of a specific class of AHM. Methodological limitations of the studies prevent definitive conclusions. Further work is now needed to evaluate the class of AHM and cognitive outcomes in future RCTs, with a particular focus on the drugs with the promising results in both animals and human observational studies.
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Yaşar et al. (2016) conducted a review in Cognitive impairment and dementia. Antihypertensive medications (CCB, ARB, ACE-I, BB, diuretics) vs. Other antihypertensives, no antihypertensives, or placebo was evaluated on Incident cognitive decline or dementia. All classes of antihypertensive medications showed similar patterns with most studies reporting point estimates below one for dementia risk, though few reached statistical significance for a specific class.
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