title: Angiotensin-receptor blockers and risk of Alzheimer's disease in hypertension population--a nationwide cohort study.
abstract: BACKGROUND
  Although emerging evidence shows angiotensin-receptor blockers (ARBs) may have a beneficial effect against Alzheimer's disease (AD), the association is not consistent. We investigated the association between ARB use and the risk of development of AD using a nationwide, population-based cohort database in Taiwan.
  
  
  RESULTS
  In total, 16,426 newly diagnosed hypertensive patients who were administered ARB without a previous diagnosis of AD were identified from the Taiwan National Health Insurance database. The comparison group consisted of hypertensive patients who did not receive ARB, and were matched to exposed individuals using propensity score by enrolled time, age, sex, and comorbidities. During an average of 5.24 ± 2.01 years of follow-up, a total of 1,031 cases (3.13%) of new AD occurred. The log-rank test showed no significant difference in the AD occurrence rate between subjects exposed to ARBs and non-exposed controls [488 (2.97%) vs. 543 (3.29%), P=0.221]. After adjusting for age, sex, comorbidities, and medications, only advanced age [hazard ratio (HR) 1.12, 95% confidence interval (CI) 1.12-1.13, P<0.001), female sex (HR 1.18, 95% CI 1.04-1.33, P=0.011), diabetes (HR 1.53, 95% CI 1.31-1.79, P<0.001), but not ARB (HR 1.08, 95% CI 0.96-1.22, P=0.222) were independently associated with AD development.
  
  
  CONCLUSIONS
  The use of ARB was not significantly associated with a reduction of risk of AD in Asian patients with essential hypertension.
authors.affiliation: Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Chien-Yi
authors.initials: CY
authors.lastname: Hsu
authors.forename: Chin-Chou
authors.initials: CC
authors.lastname: Huang
authors.forename: Wan-Leong
authors.initials: WL
authors.lastname: Chan
authors.forename: Po-Hsun
authors.initials: PH
authors.lastname: Huang
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Chiang
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.forename: Chia-Min
authors.initials: CM
authors.lastname: Chung
authors.forename: Shing-Jong
authors.initials: SJ
authors.lastname: Lin
authors.forename: Jaw-Wen
authors.initials: JW
authors.lastname: Chen
authors.forename: Hsin-Bang
authors.initials: HB
authors.lastname: Leu
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000544:Alzheimer Disease / Q000401:mortality*; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000401:mortality; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D012307:Risk Factors; D017678:Sex Distribution; D020521:Stroke / Q000401:mortality; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents