Antihypertensive Medication Regimen Intensity and Incident Dementia in an Older Population

Edwin C.K. Tan, Chengxuan Qiu, Yajun Liang, Rui Wang, J. Simon Bell, Johan Fastbom, Laura Fratiglioni, Kristina Johnell

Research output: Contribution to journalArticle

Abstract

Objective: To investigate the association between antihypertensive medication regimen intensity and risk of incident dementia in an older population. Design: Prospective, longitudinal cohort study. Participants/Setting: A total of 1208 participants aged ≥78 years, free of dementia, and residing in central Stockholm at baseline (2001-2004). Measurements: Participants were examined at 3- and 6-year follow-up to detect incident dementia. Data were collected through face-to-face interviews, clinical examinations, and laboratory tests. Data on antihypertensive use were obtained by a physician through patient self-report, visual inspection, or medical records. Cox proportional hazards models were used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between time-varying antihypertensive regimen intensity and incident dementia after adjusting for potential confounders. Results: During the follow-up period, 125 participants were diagnosed with dementia. Participants who developed dementia were more likely to have vascular disease at baseline (66.4% vs 55.3%, P = .02). In fully adjusted analyses, the number of antihypertensive classes (HR 0.68, 95% CI 0.55-0.84) and total prescribed daily dose (HR 0.70, 95% CI 0.57-0.86) were significantly associated with reduced dementia risk. After considering all-cause mortality as a competing risk, the number (HR 0.75, 95% CI 0.62-0.91) and doses (HR 0.71, 95% CI 0.59-0.86) of antihypertensive classes, and the independent use of diuretics (HR 0.66, 95% CI 0.44-0.99), were significantly associated with lower dementia risk. Conclusions: Greater intensity of antihypertensive drug use among older people may be associated with reduced incidence of dementia.

LanguageEnglish
Number of pages7
JournalJournal of the American Medical Directors Association
DOIs
StateAccepted/In press - 2018

Keywords

  • Antihypertensive agents
  • Cardiovascular diseases
  • Dementia
  • Longitudinal studies
  • Prospective studies

Cite this

Tan, Edwin C.K. ; Qiu, Chengxuan ; Liang, Yajun ; Wang, Rui ; Bell, J. Simon ; Fastbom, Johan ; Fratiglioni, Laura ; Johnell, Kristina. / Antihypertensive Medication Regimen Intensity and Incident Dementia in an Older Population. In: Journal of the American Medical Directors Association. 2018
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abstract = "Objective: To investigate the association between antihypertensive medication regimen intensity and risk of incident dementia in an older population. Design: Prospective, longitudinal cohort study. Participants/Setting: A total of 1208 participants aged ≥78 years, free of dementia, and residing in central Stockholm at baseline (2001-2004). Measurements: Participants were examined at 3- and 6-year follow-up to detect incident dementia. Data were collected through face-to-face interviews, clinical examinations, and laboratory tests. Data on antihypertensive use were obtained by a physician through patient self-report, visual inspection, or medical records. Cox proportional hazards models were used to compute hazard ratios (HRs) and 95{\%} confidence intervals (CIs) for the association between time-varying antihypertensive regimen intensity and incident dementia after adjusting for potential confounders. Results: During the follow-up period, 125 participants were diagnosed with dementia. Participants who developed dementia were more likely to have vascular disease at baseline (66.4{\%} vs 55.3{\%}, P = .02). In fully adjusted analyses, the number of antihypertensive classes (HR 0.68, 95{\%} CI 0.55-0.84) and total prescribed daily dose (HR 0.70, 95{\%} CI 0.57-0.86) were significantly associated with reduced dementia risk. After considering all-cause mortality as a competing risk, the number (HR 0.75, 95{\%} CI 0.62-0.91) and doses (HR 0.71, 95{\%} CI 0.59-0.86) of antihypertensive classes, and the independent use of diuretics (HR 0.66, 95{\%} CI 0.44-0.99), were significantly associated with lower dementia risk. Conclusions: Greater intensity of antihypertensive drug use among older people may be associated with reduced incidence of dementia.",
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Antihypertensive Medication Regimen Intensity and Incident Dementia in an Older Population. / Tan, Edwin C.K.; Qiu, Chengxuan; Liang, Yajun; Wang, Rui; Bell, J. Simon; Fastbom, Johan; Fratiglioni, Laura; Johnell, Kristina.

In: Journal of the American Medical Directors Association, 2018.

Research output: Contribution to journalArticle

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AU - Tan,Edwin C.K.

AU - Qiu,Chengxuan

AU - Liang,Yajun

AU - Wang,Rui

AU - Bell,J. Simon

AU - Fastbom,Johan

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AU - Johnell,Kristina

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N2 - Objective: To investigate the association between antihypertensive medication regimen intensity and risk of incident dementia in an older population. Design: Prospective, longitudinal cohort study. Participants/Setting: A total of 1208 participants aged ≥78 years, free of dementia, and residing in central Stockholm at baseline (2001-2004). Measurements: Participants were examined at 3- and 6-year follow-up to detect incident dementia. Data were collected through face-to-face interviews, clinical examinations, and laboratory tests. Data on antihypertensive use were obtained by a physician through patient self-report, visual inspection, or medical records. Cox proportional hazards models were used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between time-varying antihypertensive regimen intensity and incident dementia after adjusting for potential confounders. Results: During the follow-up period, 125 participants were diagnosed with dementia. Participants who developed dementia were more likely to have vascular disease at baseline (66.4% vs 55.3%, P = .02). In fully adjusted analyses, the number of antihypertensive classes (HR 0.68, 95% CI 0.55-0.84) and total prescribed daily dose (HR 0.70, 95% CI 0.57-0.86) were significantly associated with reduced dementia risk. After considering all-cause mortality as a competing risk, the number (HR 0.75, 95% CI 0.62-0.91) and doses (HR 0.71, 95% CI 0.59-0.86) of antihypertensive classes, and the independent use of diuretics (HR 0.66, 95% CI 0.44-0.99), were significantly associated with lower dementia risk. Conclusions: Greater intensity of antihypertensive drug use among older people may be associated with reduced incidence of dementia.

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