Unknown

Dataset Information

0

Antihypertensive Medication and Dementia Risk in Older Adult African Americans with Hypertension: A Prospective Cohort Study.


ABSTRACT: BACKGROUND:African Americans are especially at risk of hypertension and dementia. Antihypertensive medications reduce the risk of cardiovascular events, but may also reduce the risk of dementia. OBJECTIVE:To assess the longitudinal effects of antihypertensive medications and blood pressure on the onset of incident dementia in a cohort of African Americans. DESIGN:Prospective cohort. PARTICIPANTS:1236 community-dwelling patients from an inner-city public health care system, aged 65 years and older, with a history of hypertension but no history of dementia, and who had at least three primary care visits and a prescription filled for any medication. MAIN MEASURES:Blood pressure was the average of three seated measurements. Dementia was diagnosed using a two-stage design, with a screening evaluation every 2 to 3 years followed by a comprehensive in-home clinical evaluation for those with a positive screen. Laboratory, inpatient and outpatient encounter data, coded diagnoses and procedures, and medication records were derived from a health information exchange. KEY RESULTS:Of the 1236 hypertensive participants without dementia at baseline, 114 (9%) developed incident dementia during follow-up. Individuals prescribed any antihypertensive medication (n?=?816) were found to have a significantly reduced risk of dementia (HR?=?0.57, 95% CI 0.37-0.88, p?=?0.0114) compared to untreated hypertensive participants (n?=?420). When this analysis was repeated including a variable indicating suboptimally treated blood pressure (> 140 mmHg systolic or >90 mmHg diastolic), the effect of antihypertensive medication was no longer statistically significant (HR?=?0.65, 95% CI 0.32-1.30, p?=?0.2217). CONCLUSIONS:Control of blood pressure in older adult African American patients with hypertension is a key intervention for preventing dementia, with similar benefits from most of the commonly available antihypertensive medications.

SUBMITTER: Murray MD 

PROVIDER: S-EPMC5880772 | BioStudies | 2018-01-01

REPOSITORIES: biostudies

Similar Datasets

2013-01-01 | S-EPMC3708346 | BioStudies
2019-01-01 | S-EPMC7223638 | BioStudies
2008-01-01 | S-EPMC2596500 | BioStudies
2019-01-01 | S-EPMC6760841 | BioStudies
1000-01-01 | S-EPMC5145748 | BioStudies
2017-01-01 | S-EPMC5466494 | BioStudies
2018-01-01 | S-EPMC6233674 | BioStudies
2020-01-01 | S-EPMC7455301 | BioStudies
2008-01-01 | S-EPMC2561300 | BioStudies
2014-01-01 | S-EPMC4102827 | BioStudies