Risk of dementia in primary aldosteronism compared with essential hypertension: a nationwide cohort study

Although hypertension is a critical risk factor for dementia, the association between primary aldosteronism (PA) and dementia has been scarcely reported. We aimed to investigate whether the risk of dementia in patients with PA was elevated compared with patients with essential hypertension (EH). Fro...

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Published in:Alzheimer's research & therapy 2023-08, Vol.15 (1), p.136-136, Article 136
Main Authors: Hong, Namki, Kim, Kyoung Jin, Yu, Min Heui, Jeong, Seong Ho, Lee, Seunghyun, Lim, Jung Soo, Rhee, Yumie
Format: Article
Language:English
Subjects:
Alzheimer
Alzheimer's disease
Antihypertensives
Codes
Cohort analysis
Complications and side effects
Dementia
Endocrine disorders
Essential hypertension
Heart attacks
Hyperaldosteronism
Hypertension
Kidney diseases
Metabolic disorders
National health insurance
Risk factors
s disease
Statistics
Stroke
Vascular dementia
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Summary:Although hypertension is a critical risk factor for dementia, the association between primary aldosteronism (PA) and dementia has been scarcely reported. We aimed to investigate whether the risk of dementia in patients with PA was elevated compared with patients with essential hypertension (EH). From the National Health Insurance Claim database in Korea (2003-2017), 3,687 patients with PA (adrenalectomy [ADX], n = 1,339, mineralocorticoid receptor antagonist [MRA] n = 2,348) with no prior dementia were age- and sex-matched at a 1:4 ratio to patients with EH (n = 14,741). The primary outcomes were all-cause dementia events, including Alzheimer's disease, vascular dementia, or other dementia combined with a prescription of one or more medications for dementia (donepezil, galantamine, memantine, or rivastigmine). Multivariable Cox regression models were used to evaluate the hazard ratios (HRs) and 95% confidence intervals for the outcome incidence rates between patients with PA and their EH matches. During a median follow-up of 5.2 years, there were 156 cases of all-cause dementia (4.2%), 140 cases of Alzheimer's disease (3.8%), and 65 cases of vascular dementia (1.8%). Compared with EH, the risk of all-cause dementia was increased in treated PA (unadjusted hazard ratio [HR] 1.26; p 
ISSN:1758-9193
1758-9193
DOI:10.1186/s13195-023-01274-x