title: Antihypertensive drug use and risk of cognitive decline in the very old: an observational study - the Newcastle 85+ Study.
abstract: OBJECTIVE
  Older adults are a fast growing group in society and are at high risk of hypertension, cognitive decline and dementia. Antihypertensive drugs, particularly calcium channel blockers (CCB), have been associated with a decreased risk of cognitive decline and dementia. We used observational data to examine the association between antihypertensive drug class and change in cognitive function.
  
  
  METHODS
  The Newcastle 85+ Study is a population-based cohort study recruiting individuals aged 85 (born in 1921) via general/family practices in Newcastle/North Tyneside, United Kingdom. Data, including blood pressure, antihypertensive drug use and cognitive function [assessed using the Standardized Mini-Mental State Exam (SMMSE)], were collected at baseline and 3-year follow-up.
  
  
  RESULTS
  The study population comprised 238 participants with a diagnosis of hypertension, prescribed antihypertensive drug treatment and with baseline and follow-up SMMSE assessment. There was an association between CCB use and less cognitive decline over 3 years (rate of decline was lower by 1.29 SMMSE points (95% confidence interval 0.16-2.42; P = 0.03) compared with those taking other antihypertensive classes after adjustment for age, sex, years of education, baseline SMMSE score, smoking, BMI, baseline blood pressure, and incident cerebrovascular event. This finding was even stronger in the cognitively intact (SMMSE >24), wherein rate of cognitive decline was lower by 1.33 SMMSE points (95% confidence interval 0.30-2.37; P = 0.01), but was not seen for other antihypertensive classes.
  
  
  CONCLUSIONS
  Findings provide support for an association between CCB use and a lower rate of cognitive decline in very old adults with hypertension.
authors.affiliation: aImperial Clinical Trials Unit, School of Public Health, St Mary's Campus, Imperial College London bInstitute of Health and Society cInstitute for Cell and Molecular Biosciences, Newcastle University dNewcastle University Institute for Ageing, Campus for Ageing and Vitality, Newcastle upon Tyne, UK.
authors.forename: Ruth
authors.initials: R
authors.lastname: Peters
authors.forename: Joanna
authors.initials: J
authors.lastname: Collerton
authors.forename: Antoneta
authors.initials: A
authors.lastname: Granic
authors.forename: Karen
authors.initials: K
authors.lastname: Davies
authors.forename: Thomas
authors.initials: T
authors.lastname: Kirkwood
authors.forename: Carol
authors.initials: C
authors.lastname: Jagger
mesh_terms: D000369:Aged, 80 and over; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000150:complications*; D015331:Cohort Studies; D003704:Dementia / Q000150:complications*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D008297:Male; D012307:Risk Factors; D006113:United Kingdom
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers