title: Relationship Between Antihypertensive Medications and Cognitive Impairment: Part I. Review of Human Studies and Clinical Trials.
abstract: There is an established association between hypertension and increased risk of poor cognitive performance and dementia including Alzheimer's disease; however, associations between antihypertensive medications (AHMs) and dementia risk are less consistent. An increased interest in AHM has resulted in expanding publications; however, none of the recent reviews are comprehensive. Our extensive review includes 15 observational and randomized controlled trials (RCTs) published over the last 5 years, assessing the relationship between AHM and cognitive impairment.
  
  
  
  All classes of AHM showed similar result patterns in human studies with the majority of study results reporting point estimates below one and only a small number of studies (N = 15) reporting statistically significant results in favor of a specific class. Only a small number of studies reported statistically significant results in favor of a specific class of AHM. Methodological limitations of the studies prevent definitive conclusions. Further work is now needed to evaluate the class of AHM and cognitive outcomes in future RCTs, with a particular focus on the drugs with the promising results in both animals and human observational studies.
authors: Division of Geriatric Medicine and Gerontology, Department of Medicine, Baltimore, Johns Hopkins School of Medicine, Baltimore, MD, 21224, USA.
authors: Sevil
authors: S
authors: Yasar
authors: Division of Geriatric Medicine and Gerontology, Department of Medicine, Baltimore, Johns Hopkins School of Medicine, Baltimore, MD, 21224, USA.
authors: Mattan
authors: M
authors: Schuchman
authors: School of Health and Related Research, University of Sheffield, Sheffield, UK.
authors: Jean
authors: J
authors: Peters
authors: Centre for Research on Ageing, Health and Wellbeing, College of Medicine, Biology and Environment Australian National University, Canberra, Australia.
authors: Kaarin J
authors: KJ
authors: Anstey
authors: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21224, USA.
authors: Michelle C
authors: MC
authors: Carlson
authors: School of Public Health, Imperial College London, London, SW7 2AZ, UK. r.peters@imperial.ac.uk.
authors: Ruth
authors: R
authors: Peters
mesh_terms: D000544:Alzheimer Disease / Q000503:physiopathology* / Q000517:prevention & control*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D060825:Cognitive Dysfunction / Q000503:physiopathology* / Q000517:prevention & control*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology*; D064887:Observational Studies as Topic; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013223:Statistics as Topic
chemical_list: D000959:Antihypertensive Agents
keywords: Alzheimer’s disease; Antihypertensive medication; Cognitive decline; Dementia