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September 1, 2019The Indian Journal of Medical ResearchOpen Access

ACE inhibitors reduced blood pressure in Alzheimer's patients, with carriers of Alu DD, rs1800764-C, or rs4291-AT showing significantly better blood pressure lowering effects.

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Why the study?

Neurodegeneration influences blood pressure variations and vascular risk factors impair renal function and cerebral perfusion, prompting study into how pharmacogenetics affect cardiovascular risk measures during ACE inhibitor and statin therapy in Alzheimer's dementia.

Does the pharmacological response of blood pressure and creatinine clearance to ACE inhibitors and statins vary by genetic polymorphisms in patients with Alzheimer's dementia?

Population

193 consecutive patients with Alzheimer's dementia

Comparison

Effects of ACE inhibitors and statins across different genetic polymorphisms and haplotypes

Design

Prospective cohort study

Follow-up

One year

Key result

ACE inhibitors reduced blood pressure in Alzheimer's patients, with carriers of Alu DD, rs1800764-C, or rs4291-AT showing significantly better blood pressure lowering effects.

Authors

FOFabricio Ferreira de OliveiraJBJuliana Marília BerrettaGAGuido Veiga de Almeida

Discussion

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Overview

Genetic variants may modulate ACE inhibitor BP response in Alzheimer's; hypothesis-generating, needs prospective validation before clinical use.

Study Design

Type

Cohort (n=193)

Blinding

Single-blind

Multicenter

No

Structured PICO

Does the pharmacological response of blood pressure and creatinine clearance to ACE inhibitors and statins vary by genetic polymorphisms in patients with Alzheimer's dementia?

P
Population
193 outpatients with Alzheimer's dementia, mean age 78 years, were prospectively followed for one year to assess the pharmacogenetic effects of ACE inhibitors and statins on cardiovascular risk measures.
E
Exposure
ACE inhibitors and statins (pharmacogenetic analysis of ACE, LDLR, and LXR-β gene variants)
C
Comparator
Non-users of ACE inhibitors or statins, and comparison across different genetic variants
O
Outcome
Variation in one year of creatinine clearance, systolic and diastolic blood pressuresurrogate

The pharmacological response of blood pressure and creatinine clearance to ACE inhibitors and statins in patients with Alzheimer's dementia may be genetically mediated.

Limitations

  • Conducted in a single centre
  • Short follow-up of one year
  • No randomization
  • Lacking measurements of serum levels of the ACE
  • No objective evaluation of sarcopenia
  • Unknown whether pharmacogenetic effects were dose-dependent or affected by treatment duration

Cite This Study

Oliveira et al. (2019) conducted a cohort in Alzheimer's dementia (n=193). ACE inhibitors and statins vs. Non-users was evaluated on Variation in one year of creatinine clearance, systolic and diastolic blood pressure. ACE inhibitors reduced blood pressure in Alzheimer's patients, with carriers of Alu DD, rs1800764-C, or rs4291-AT showing significantly better blood pressure lowering effects.

synapsesocial.com/papers/6a96f786dbc641e6a0a6ecbehttps://doi.org/10.4103/ijmr.ijmr_1209_17
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