Key result
Antihypertensive medication use was significantly associated with lower cerebral β-amyloid deposition (B = -0.104) in older adults with hypertension compared to non-users.
Why the study?
It was unclear whether antihypertensive medication use is associated with in vivo Alzheimer's disease pathologies in older adults with hypertension, and whether effects differ by drug class and blood-brain barrier permeability.
Does antihypertensive medication use reduce cerebral β-amyloid and tau deposition in older adults with hypertension?
Cross-Sectional (n=408)
Yes
Does antihypertensive medication use reduce cerebral β-amyloid and tau deposition in older adults with hypertension?
Antihypertensive medication use, particularly renin-angiotensin system inhibitors, is associated with lower cerebral β-amyloid deposition in older adults with hypertension.
Answers are grounded in this paper and cite their sources.
Should not change antihypertensive prescribing; leaves open whether treatment modifies cerebral amyloid deposition.
Objective We investigated whether the use of antihypertensive medication (AHM) is associated with in vivo Alzheimer's Disease (AD) pathologies in older adults with hypertension and examined if the effect differs by drug‐class and blood–brain barrier (BBB) permeability of the drug. Methods This cross‐sectional study recruited participants from the Korean Brain Aging Study for the Early Diagnosis and Prevention of Alzheimer's Disease. Participants comprised both cognitively normal and impaired older adults diagnosed with hypertension (n = 408). All participants underwent comprehensive clinical assessment and [11C] Pittsburgh Compound B positron emission tomography (PET) for measurement of cerebral β‐amyloid (Aβ) deposition. Additionally, a subset of participants (n = 120) was subjected to [18F] AV‐1451 PET to assess tau deposition. Results The AHM group (n = 227) exhibited significantly lower Aβ deposition (B [SE] = −0.104 [0.037], p = 0.006) compared to the non‐AHM group (n = 181), even after controlling for age, sex, apolipoprotein E ε4‐positivity, vascular risk factors, and mean arterial blood pressure. Further analysis by AHM class showed an association between the use of renin‐angiotensin system inhibitors (RASi) and less Aβ deposition (B [SE] = −0.143[0.049], p = 0.004). No significant relationships were observed between the use of BBB‐permeable AHM and Aβ deposition. Additionally, associations between AHM use and tau deposition did not reach statistical significance. Interpretation Our findings suggest that AHM use may be associated with lower Aβ burden in older adults with hypertension. Further studies exploring the underlying mechanism, particularly related to RASi, may provide insights into new therapeutic targets for AD. ANN NEUROL 2025;97:1051–1061
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Keum et al. (2025) conducted a cross-sectional in Hypertension (n=408). Antihypertensive medication (AHM) vs. Non-AHM group was evaluated on Cerebral β-amyloid (Aβ) deposition (B = -0.104, 95% CI -0.18 to -0.03, p=0.006). Antihypertensive medication use was significantly associated with lower cerebral β-amyloid deposition (B = -0.104) in older adults with hypertension compared to non-users.
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