Antihypertensive medication use and incident Alzheimer disease: the Cache County Study.
BACKGROUND
Recent reports suggest that antihypertensive (AH) medications may reduce the risk of dementing illnesses.


OBJECTIVE
To examine the relationship of AH medication use with incidence of Alzheimer disease (AD) among the elderly population (aged 65 years and older) of Cache County, Utah, and to examine whether the relationship varies with different classes of AH medications.


METHODS
After an initial (wave 1) multistage assessment (1995 through 1997) to identify prevalent cases of dementia, we used similar methods 3 years later (wave 2) to identify 104 incident cases of AD among the 3308 survivors. At the baseline assessment, we obtained a detailed drug inventory from the study participants. We carried out discrete time survival analyses to examine the association between the use of AH medications (including angiotensin converting enzyme inhibitors, beta-blockers, calcium channel blockers, and diuretics) at baseline with subsequent risk of AD.


RESULTS
Use of any AH medication at baseline was associated with lower incidence of AD (adjusted hazard ratio, 0.64; 95% confidence interval, 0.41-0.98). Examination of medication subclasses showed that use of diuretics (adjusted hazard ratio, 0.57; 95% confidence interval, 0.33-0.94), and specifically potassium-sparing diuretics (adjusted hazard ratio, 0.26; 95% confidence interval, 0.08-0.64), was associated with the greatest reduction in risk of AD. Corresponding analysis with a fully examined subsample controlling for blood pressure measurements did not substantially change our findings.


CONCLUSIONS
These data suggest that AH medications, and specifically potassium-sparing diuretics, are associated with reduced incidence of AD. Because the latter association is a new finding, it requires confirmation in further study.
Khachaturian and Associates Inc., Potomac, MD, USA.
Ara S
AS
Khachaturian
Peter P
PP
Zandi
Constantine G
CG
Lyketsos
Kathleen M
KM
Hayden
Ingmar
I
Skoog
Maria C
MC
Norton
JoAnn T
JT
Tschanz
Lawrence S
LS
Mayer
Kathleen A
KA
Welsh-Bohmer
John C S
JC
Breitner
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000453:epidemiology; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D012189:Retrospective Studies
D000959:Antihypertensive Agents