title: Antihypertensive drugs decrease risk of Alzheimer disease: Ginkgo Evaluation of Memory Study.
abstract: OBJECTIVE
  The aim of this study was to determine whether use of diuretics, angiotensin-1 receptor blockers (ARB), angiotensin-converting enzyme inhibitors (ACE-I), calcium channel blockers (CCB), or β-blockers (BB) was associated with a reduced risk of Alzheimer disease (AD) dementia in participants with normal cognition or mild cognitive impairment (MCI).
  
  
  METHODS
  Secondary longitudinal data analysis of the Ginkgo Evaluation of Memory Study in older adults at least 75 years of age with normal cognition (n = 1,928) or MCI (n = 320) over a median 6.1-year period using Cox proportional hazard models after adjusting for confounders.
  
  
  RESULTS
  Diuretic use was reported by 15.6%, ARB 6.1%, ACE-I 15.1%, CCB 14.8%, and BB 20.5%. Of the 2,248 participants, 290 (13%) developed AD dementia. Hazard ratio for incident AD dementia among participants with normal cognition was 0.51 in diuretic (95% confidence interval [CI] 0.31-0.82), 0.31 in ARB (95% CI 0.14-0.68), 0.50 in ACE-I (95% CI 0.29-0.83), 0.62 in CCB (95% CI 0.35-1.09), and 0.58 in BB (95% CI 0.36-0.93) users and was not significantly altered when mean systolic blood pressure was above 140 mm Hg. In participants with MCI, only diuretic use was associated with decreased risk (hazard ratio = 0.38, 95% CI 0.20-0.73).
  
  
  CONCLUSIONS
  Diuretic, ARB, and ACE-I use was, in addition to and/or independently of mean systolic blood pressure, associated with reduced risk of AD dementia in participants with normal cognition, while only diuretic use was associated with reduced risk in participants with MCI.
authors.affiliation: The Johns Hopkins University, Baltimore, MD, USA. syasar1@jhmi.edu
authors.forename: Sevil
authors.initials: S
authors.lastname: Yasar
authors.forename: Jin
authors.initials: J
authors.lastname: Xia
authors.forename: Wenliang
authors.initials: W
authors.lastname: Yao
authors.forename: Curt D
authors.initials: CD
authors.lastname: Furberg
authors.forename: Qian-Li
authors.initials: QL
authors.lastname: Xue
authors.forename: Carla I
authors.initials: CI
authors.lastname: Mercado
authors.forename: Annette L
authors.initials: AL
authors.lastname: Fitzpatrick
authors.forename: Linda P
authors.initials: LP
authors.lastname: Fried
authors.forename: Claudia H
authors.initials: CH
authors.lastname: Kawas
authors.forename: Kaycee M
authors.initials: KM
authors.lastname: Sink
authors.forename: Jeff D
authors.initials: JD
authors.lastname: Williamson
authors.forename: Steven T
authors.initials: ST
authors.lastname: DeKosky
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Carlson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000208:ethnology / Q000517:prevention & control* / Q000523:psychology; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D060825:Cognitive Dysfunction / Q000188:drug therapy* / Q000208:ethnology / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D020441:Ginkgo biloba; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008568:Memory / Q000187:drug effects* / Q000502:physiology; D012307:Risk Factors
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers
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