title: Risk of incident dementia in drug-untreated arterial hypertension: a population-based study.
abstract: Arterial hypertension in midlife may increase the risk of late-life dementia. Notably, there is conflicting data as to whether hypertension in the elderly (age 65 years and older) is a risk factor for dementia and Alzheimer's disease (AD). We determined whether drug-untreated hypertension was associated with a higher risk of incident dementia and AD. In a population-based study of older people in central Spain (NEDICES), non-demented participants were followed prospectively. Dementia at follow-up was diagnosed using DSM-IV criteria. Using Cox proportional hazards models, the risk of dementia was estimated in participants with drug-untreated hypertension and in participants with drug-treated hypertension versus controls. The 3,824 participants had a mean duration of follow-up of 3.2 years. Sixty-two (3.3%) of 1,870 participants without baseline hypertension developed incident dementia versus 78 (4.7%) of 1,657 with drug-treated, baseline hypertension and 19 (12.0%) with drug-untreated, baseline hypertension. In an unadjusted Cox model, risk of dementia was increased in participants with drug-untreated hypertension (relative risk [RR] =1.93, 95% confidence interval [CI]=1.15–3.23, p = 0.01) and in participants with drug-treated hypertension (RR =1.43, 95% CI= 1.02–2.0, p =0.035) versus participants without hypertension (reference group). In a fully adjusted Cox model, the risk of dementia remained increased in participants with drug-untreated hypertension (RR =2.38, 95% CI =1.32–4.29, p=0.004). Results were similar for risk of AD. Our results suggest that drug-untreated hypertension may be an independent risk factor for dementia and AD in the elderly.
authors.affiliation: Department of Neurology, University Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Félix
authors.initials: F
authors.lastname: Bermejo-Pareja
authors.forename: Julián
authors.initials: J
authors.lastname: Benito-León
authors.forename: Elan D
authors.initials: ED
authors.lastname: Louis
authors.forename: Rocío
authors.initials: R
authors.lastname: Trincado
authors.forename: Eva
authors.initials: E
authors.lastname: Carro
authors.forename: Alberto
authors.initials: A
authors.lastname: Villarejo
authors.forename: Agustín Gómez
authors.initials: AG
authors.lastname: de la Cámara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D011159:Population Surveillance; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires