Antihypertensive medication is associated with less cognitive impairment in the very old with apolipoprotein-E epsilon4 allele.
OBJECTIVE
High and low blood pressure and apolipoprotein (Apo)-E epsilon4 alleles have been shown to be associated with dementia of the Alzheimer's type. The aim of this study was to examine the relationship between Apo-E epsilon4 allele status and the effect of antihypertensive treatment on cognitive performance in persons > or =80 years of age.


METHODS
A sample of 258 individuals 80-102 years of age was studied. Associations between the Mini-Mental State Examination (MMSE) score and treatment with antihypertensive medication, blood pressure, Apo-E polymorphism, sex, age and education were assessed. Patients treated with antihypertensive drugs typically used two to ten different medications.


RESULTS
Individuals with no Apo-E epsilon4 alleles who were not treated with antihypertensive medications had a significantly higher diastolic blood pressure than other participants in the study but no cognitive deficits. Participants who had at least one Apo-E epsilon4 allele who were not treated with antihypertensive medications scored significantly lower on the MMSE compared with other participants in the study.


CONCLUSIONS
Individuals with an Apo-E epsilon4 allele who were not treated with antihypertensive medication showed the poorest cognitive performance. This could suggest that individuals with the Apo-E epsilon4 allele may benefit cognitively from treatment with antihypertensive drugs.
Hestad
Knut A
KA
Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, NorwayInnlandet Hospital-Sanderud, Ottestad, Norway. knut.hestad@svt.ntnu.no
Engedal
Knut
K
D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D001057:Apolipoproteins E / Q000235:genetics*; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000209:etiology / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D008609:Mental Status Schedule; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D001057:Apolipoproteins E