HYPERTENSION, a condition that affects 1.3 billion people worldwide, is a leading cause of strokes and cerebrovascular disease. Recent research has shown that antihypertensive medications may reduce the risk of all-cause dementia by 13% and Alzheimer’s disease (AD) by 16% in those with elevated blood pressure (BP). However, the relationship between BP, antihypertensive use, and AD risk varies in different populations.
The study, led by Matthew Lennon, University of New South Wales, Sydney, Australia, aimed to understand the relationship between hypertension, antihypertensive use, and dementia risk, particularly AD and non-AD dementia. The research team conducted a meta-analysis involving 14 community-based longitudinal studies of ageing, including 31,250 participants from the Cohort Studies of Memory in an International Consortium. The cohort was 41% male with a mean age of 72.1 years.
The study found that untreated hypertension in late life significantly increased the risk of developing AD compared to both healthy individuals and those with treated hypertension. Participants with untreated hypertension were 36.3% more likely to develop AD than healthy controls and 41.8% more likely compared to those with treated hypertension. However, no increased AD risk was observed in participants with treated hypertension compared to healthy controls.
No significant difference in AD risk was found between those with treated hypertension with or without effective BP control. Untreated hypertension also posed a higher risk for vascular dementia, although this was not consistently significant after adjusting for vascular covariates.
Overall, the findings suggest that antihypertensive use could be an effective part of a prevention strategy in late life to reduce the risk of both AD and vascular dementia. However, the study also highlights the need for more research to understand the specific impact of BP and antihypertensive use on AD risk, especially across different age groups, sexes, and ethnicities.
Katie Wright, EMJ
Reference
Lennon MJ et al. Blood pressure, antihypertensive use, and late-life Alzheimer and non-Alzheimer dementia risk: an individual participant data meta-analysis. Neurology. 2024;103(5):e209715.
