Angiotensin receptor blockers and Dementia Prevention: Don’t RAS to a Conclusion yet

• Type of Material: Article
• Authors: Sevil Yasar, Johns Hopkins University; Whitney Wharton, Emory University
• Language: English
• Date: 2022-09-07
• Publisher: Wolters Kluwer Health, Inc.
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2022, Wolters Kluwer Health
• Final Published Version (URL): https://doi.org/10.1161%2FHYPERTENSIONAHA.122.19859
• Title of Journal or Parent Work: Hypertension
• Volume: 79
• Issue: 10
• Start Page: 2170
• End Page: 2172
• Grant/Funding Information: Sevil Yasar is supported by NIH grants 2U01HL096812-09 and 1R01AG07425801.; Whitney Wharton is supported by NIH grants 1R01AG066203-01 and 1RF1AG051514-01.
• Keywords: antihypertensive medication; dementia risk; alzheimer's disease; AT1R; hypertension
• Research Categories: Health Sciences, Rehabilitation and Therapy; Health Sciences, Pharmacology

Abstract

In this issue of Hypertension®, Deng et al. 1 investigate the longitudinal effect of antihypertensive medications acting via the renin-angiotensin system. They examine the effects of both angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin 1 receptor blockers (AT1RB) in participants with hypertension and mild cognitive impairment on all-cause dementia risk and cognitive function. The authors used data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) cohort. They included 403 participants aged 74 years with a history of hypertension (defined as reported hypertension, reported use of AHM use, or systolic blood pressure ≥ 140 mmHg and diastolic blood pressure DBP ≥ 90 mmHg) and having a diagnosis of mild cognitive impairment (at baseline visit or follow-up). The cohort was followed for approximately 3 years. The authors report that participants using AT1RB had a significantly lower annual risk, 55%, 51%, and 69%, of developing dementia compared to participants using ACE-I, other- or no-antihypertensive users. In contrast, ACE-I or other-antihypertensive medication users did not show dementia risk reduction. The authors found a beneficial effect of AT1RB use over time on slowing the progression of a clinical dementia rating severity measure and verbal memory.