title: Use of diuretics is associated with reduced risk of Alzheimer's disease: the Cache County Study.
abstract: Although the use of antihypertensive medications has been associated with reduced risk of Alzheimer's disease (AD), it remains unclear which class provides the most benefit. The Cache County Study of Memory Health and Aging is a prospective longitudinal cohort study of dementing illnesses among the elderly population of Cache County, Utah. Using waves I to IV data of the Cache County Study, 3417 participants had a mean of 7.1 years of follow-up. Time-varying use of antihypertensive medications including different class of diuretics, angiotensin converting enzyme inhibitors, β-blockers, and calcium channel blockers was used to predict the incidence of AD using Cox proportional hazards analyses. During follow-up, 325 AD cases were ascertained with a total of 23,590 person-years. Use of any antihypertensive medication was associated with lower incidence of AD (adjusted hazard ratio [aHR], 0.77; 95% confidence interval [CI], 0.61-0.97). Among different classes of antihypertensive medications, thiazide (aHR, 0.7; 95% CI, 0.53-0.93), and potassium-sparing diuretics (aHR, 0.69; 95% CI, 0.48-0.99) were associated with the greatest reduction of AD risk. Thiazide and potassium-sparing diuretics were associated with decreased risk of AD. The inverse association of potassium-sparing diuretics confirms an earlier finding in this cohort, now with longer follow-up, and merits further investigation.
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Yi-Fang
authors.initials: YF
authors.lastname: Chuang
authors.affiliation: Department of Psychiatry, McGill University Faculty of Medicine, Montreal, Quebec, Canada.
authors.forename: John C S
authors.initials: JCS
authors.lastname: Breitner
authors.affiliation: Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Medicine, Far-Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Yen-Ling
authors.initials: YL
authors.lastname: Chiu
authors.affiliation: National Supercomputing Center (NSCEE) for Energy and the Environment, University of Nevada, Las Vegas, NV, USA.
authors.forename: Ara
authors.initials: A
authors.lastname: Khachaturian
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Hayden
authors.affiliation: Center for Epidemiologic Studies, Utah State University, Logan, UT, USA; Department of Mathematics and Statistics, Utah State University, Logan, UT, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Corcoran
authors.affiliation: Center for Epidemiologic Studies, Utah State University, Logan, UT, USA; Department of Psychology, Utah State University, Logan, UT, USA.
authors.forename: JoAnn
authors.initials: J
authors.lastname: Tschanz
authors.affiliation: Center for Epidemiologic Studies, Utah State University, Logan, UT, USA; Department of Psychology, Utah State University, Logan, UT, USA; Department of Family, Consumer, and Human Development, Utah State University, Logan, UT, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Norton
authors.affiliation: Center for Epidemiologic Studies, Utah State University, Logan, UT, USA.
authors.forename: Ron
authors.initials: R
authors.lastname: Munger
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Welsh-Bohmer
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: pzandi@jhsph.edu.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Zandi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology / Q000517:prevention & control*; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D062865:Diuretics, Potassium Sparing / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D012306:Risk; D049993:Sodium Chloride Symporter Inhibitors / Q000008:administration & dosage*
chemical_list: D000959:Antihypertensive Agents; D062865:Diuretics, Potassium Sparing; D049993:Sodium Chloride Symporter Inhibitors
keywords: Alzheimer's disease; Antihypertensive medications; Diuretics