title: Use of Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers, and Risk of Dementia in Heart Failure.
abstract: To test the effect of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) on reducing the risk of dementia in patients with heart failure (HF).
  
  
  
  This retrospective, longitudinal study used a cohort of HF patients identified from a local Medicare advantage prescription drug plan. Multivariable time-dependent Cox model and marginal structural model using inverse-probability-oftreatment weighting were used to estimate the risk of developing dementia. Adjusted dementia rate ratios were estimated among current and former ACEI/ARB users, as compared with nonusers.
  
  
  
  Using the time-dependent Cox model, the adjusted dementia rate ratios (95% confidence-interval) among current and former users were 0.90(0.70-1.16) and 0.89 (0.71-1.10), respectively. Use of marginal structural model resulted in similar effect estimates for current and former users as compared with the nonusers.
  
  
  
  This study found no difference in risk of dementia among the current and former users of ACEI/ARB as compared with the nonusers in an already at-risk HF population.
authors.affiliation: Retrospective Observational Studies, Evidera, Lexington, MA, USA abhishek.chitnis@evidera.com.
authors.forename: Abhishek S
authors.initials: AS
authors.lastname: Chitnis
authors.affiliation: Department of Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX, USA.
authors.forename: Rajender R
authors.initials: RR
authors.lastname: Aparasu
authors.affiliation: Department of Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX, USA.
authors.forename: Hua
authors.initials: H
authors.lastname: Chen
authors.affiliation: Houston VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA; Baylor College of Medicine; VA South Central Mental Illness Research, Education and Clinical Center.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Kunik
authors.affiliation: The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Schulz
authors.affiliation: Department of Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Johnson
mesh_terms: D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015233:Models, Statistical; D012189:Retrospective Studies; D012306:Risk
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors
keywords: angiotensin receptor blockers; angiotensin-converting enzyme inhibitors; dementia; heart failure