Antihypertensive medication use and incident Alzheimer disease: the Cache County Study.

Published

Journal Article

BACKGROUND: Recent reports suggest that antihypertensive (AH) medications may reduce the risk of dementing illnesses. OBJECTIVES: To examine the relationship of AH medication use with incidence of Alzheimer disease (AD) among the elderly population (aged 65 years and older) of Cache County, Utah, and to examine whether the relationship varies with different classes of AH medications. METHODS: After an initial (wave 1) multistage assessment (1995 through 1997) to identify prevalent cases of dementia, we used similar methods 3 years later (wave 2) to identify 104 incident cases of AD among the 3308 survivors. At the baseline assessment, we obtained a detailed drug inventory from the study participants. We carried out discrete time survival analyses to examine the association between the use of AH medications (including angiotensin converting enzyme inhibitors, beta-blockers, calcium channel blockers, and diuretics) at baseline with subsequent risk of AD. RESULTS: Use of any AH medication at baseline was associated with lower incidence of AD (adjusted hazard ratio, 0.64; 95% confidence interval, 0.41-0.98). Examination of medication subclasses showed that use of diuretics (adjusted hazard ratio, 0.57; 95% confidence interval, 0.33-0.94), and specifically potassium-sparing diuretics (adjusted hazard ratio, 0.26; 95% confidence interval, 0.08-0.64), was associated with the greatest reduction in risk of AD. Corresponding analysis with a fully examined subsample controlling for blood pressure measurements did not substantially change our findings. CONCLUSIONS: These data suggest that AH medications, and specifically potassium-sparing diuretics, are associated with reduced incidence of AD. Because the latter association is a new finding, it requires confirmation in further study.

Full Text

Duke Authors

Cited Authors

  • Khachaturian, AS; Zandi, PP; Lyketsos, CG; Hayden, KM; Skoog, I; Norton, MC; Tschanz, JT; Mayer, LS; Welsh-Bohmer, KA; Breitner, JCS

Published Date

  • May 2006

Published In

Volume / Issue

  • 63 / 5

Start / End Page

  • 686 - 692

PubMed ID

  • 16533956

Pubmed Central ID

  • 16533956

International Standard Serial Number (ISSN)

  • 0003-9942

Digital Object Identifier (DOI)

  • 10.1001/archneur.63.5.noc60013

Language

  • eng

Conference Location

  • United States