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Antihypertensive drugs reduce dementia risk among older black people

Older black patients who were prescribed antihypertension medication incurred a significantly lower risk for dementia, according to findings published in the Journal of General Internal Medicine.

“African-Americans are especially at risk of hypertension and dementia,” Michael D. Murray, PharmD, MPH, from Regenstrief Institute Inc., Indianapolis, and colleagues wrote. “Antihypertensive medications reduce the risk of cardiovascular events, but may also reduce the risk of dementia.”

Murray and colleagues conducted a prospective cohort study to investigate how antihypertensive medications and BP affect the onset of incident dementia among 1,236 community-dwelling blacks aged 65 years and older. Participants were included if they had a history of hypertension but no history of dementia and had a prescription filled for any medication at baseline.

The researchers screened participants for dementia every 2 to 3 years and then provided an in-home clinical evaluation for those who screened positive to confirm a dementia diagnosis.

Results indicated that 9% of participants developed incident dementia. The risk for dementia was 43% lower among patients who were prescribed any antihypertensive medication (n = 816) than those with hypertension who were untreated (n = 420; HR = 0.57; 95% CI, 0.37-0.88).

When accounting for suboptimally treated BP, defined as having a systolic BP greater than 140 mm Hg or a diastolic BP greater than 90 mm Hg, the risk for dementia nearly doubled (HR = 1.78; 95% CI, 1.11-2.86) and the effect of antihypertensive medication declined to a 35% lower risk for dementia (HR = 0.65; 95% CI, 0.32-1.3).

These findings suggest that dementia risk is largely influenced by BP control, according to the researchers.

“Control of blood pressure in older adult African-American patients with hypertension is a key intervention for preventing dementia, with similar benefits from most of the commonly available antihypertensive medications,” Murray and colleagues concluded. – by Alaina Tedesco

Disclosure: The authors report no relevant financial disclosures.