Use of Angiotensin Receptor Blockers and Risk of Dementia in a Predominantly Male Population: Prospective Cohort Analysis

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dc.contributor.author Li, Nien-Chen en_US
dc.contributor.author Lee, Austin en_US
dc.contributor.author Whitmer, Rachel A en_US
dc.contributor.author Kivipelto, Miia en_US
dc.contributor.author Lawler, Elizabeth en_US
dc.contributor.author Kazis, Lewis E en_US
dc.contributor.author Wolozin, Benjamin en_US
dc.date.accessioned 2012-01-11T21:07:25Z
dc.date.available 2012-01-11T21:07:25Z
dc.date.copyright 2010 en_US
dc.date.issued 2010-1-12 en_US
dc.identifier.citation Li, Nien-Chen, Austin Lee, Rachel A Whitmer, Miia Kivipelto, Elizabeth Lawler, Lewis E Kazis, Benjamin Wolozin. "Use of angiotensin receptor blockers and risk of dementia in a predominantly male population: prospective cohort analysis" BMJ: British Medical Journal 340:b5465. (2010) en_US
dc.identifier.issn 1468-5833 en_US
dc.identifier.uri http://hdl.handle.net/2144/3169
dc.description.abstract Objective To investigate whether angiotensin receptor blockers protect against Alzheimer's disease and dementia or reduce the progression of both diseases. Design Prospective cohort analysis. Setting Administrative database of the US Veteran Affairs, 2002-6. Population 819491 predominantly male participants (98%) aged 65 or more with cardiovascular disease. Main outcome measures Time to incident Alzheimer's disease or dementia in three cohorts (angiotensin receptor blockers, lisinopril, and other cardiovascular drugs, the "cardiovascular comparator") over a four year period (fiscal years 2003-6) using Cox proportional hazard models with adjustments for age, diabetes, stroke, and cardiovascular disease. Disease progression was the time to admission to a nursing home or death among participants with pre-existing Alzheimer's disease or dementia. Results Hazard rates for incident dementia in the angiotensin receptor blocker group were 0.76 (95% confidence interval 0.69 to 0.84) compared with the cardiovascular comparator and 0.81 (0.73 to 0.90) compared with the lisinopril group. Compared with the cardiovascular comparator, angiotensin receptor blockers in patients with pre-existing Alzheimer's disease were associated with a significantly lower risk of admission to a nursing home (0.51, 0.36 to 0.72) and death (0.83, 0.71 to 0.97). Angiotensin receptor blockers exhibited a dose-response as well as additive effects in combination with angiotensin converting enzyme inhibitors. This combination compared with angiotensin converting enzyme inhibitors alone was associated with a reduced risk of incident dementia (0.54, 0.51 to 0.57) and admission to a nursing home (0.33, 0.22 to 0.49). Minor differences were shown in mean systolic and diastolic blood pressures between the groups. Similar results were observed for Alzheimer's disease. Conclusions Angiotensin receptor blockers are associated with a significant reduction in the incidence and progression of Alzheimer's disease and dementia compared with angiotensin converting enzyme inhibitors or other cardiovascular drugs in a predominantly male population. en_US
dc.description.sponsorship Retirement Research Foundation; Casten Foundation en_US
dc.language.iso en en_US
dc.publisher BMJ Publishing Group Ltd. en_US
dc.rights Copyright Li et al 2010 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode. en_US
dc.title Use of Angiotensin Receptor Blockers and Risk of Dementia in a Predominantly Male Population: Prospective Cohort Analysis en_US
dc.type article en_US
dc.identifier.doi 10.1136/bmj.b5465 en_US
dc.identifier.pubmedid 20068258 en_US
dc.identifier.pmcid 2806632 en_US

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