Antihypertensive medication and dementia risk in patients with hypertension: A nationwide population-based study

• Published in: Journal of clinical neuroscience 2024-07, Vol.125, p.83-94
• Main Authors: Lin, Chih-Ying, Chen, Pei-Hsien, Tsai, Chiu-Lin, Hsieh, Yow-Wen, Hu, Kai-Chieh, Tsai, Fuu-Jen, Cho, Der-Yang, Liao, Hsien-Yin
• Format: Article
• Language: English
• Subjects: Alzheimer’s disease; Antihypertension medication; Dementia; Hypertension; traditional Chinese medicine
• ISSN: 0967-5868; 1532-2653
• DOI: 10.1016/j.jocn.2024.05.006

•Hypertension may be a significant risk factor for dementia.•The use of antihypertensive medications could lower the risk of progression of newly diagnosed dementia in hypertensive patients.•CCBs and ARBs are recommended first-line AHMs for hypertensive patients that could significantly reduce the risk of getting dementia.•The use of traditional Chinese medicine could reduce the development of newly diagnosed dementia after hypertension. The claim between hypertension and dementia needs more evidence due to limited data. We aim to examine the risk of dementia in patients with hypertension, and determine whether the use of antihypertensive medications (AHMs) could decrease the incidence of dementia diagnosed following the onset of hypertension. We employed the Taiwan National Health Insurance Research Database from 2000 to 2016 and performed a retrospective cohort study. We also carried out a case-control study to see if AHMs could reduce the incidence of newly diagnosed dementia in hypertensive patients. In the retrospective cohort study, we selected 587,762 participants with age and gender matched in experimental and control groups. The hypertension group had significantly higher adjusted hazard ratios (aHRs) of getting newly diagnosed dementia, including all-cause dementia, Alzheimer’s disease, and vascular dementia (aHR, 2.86; 95 % confidence interval (CI), 2.74–2.99) than the control group. Three kinds of specific AHMs, namely, angiotensin II receptor blockers (aHR, 0.55; 95 % CI, 0.53–0.57), calcium channel blockers (aHR, 0.76; 95 % CI, 0.73–0.80), and diuretics (aHR,0.93; 95 % CI, 0.89–0.97) could significantly decrease the incidence of getting newly diagnosed dementia. Also, the application of traditional Chinese medicine (TCM) significantly associates with the lower aHRs of newly diagnosed dementia in hypertensive patients compared to patients without TCM (aHR, 0.90; 95 % CI, 0.81–1.00). Hypertension may be a significant risk factor for dementia. Both AHMs and TCM significantly associate with the lower incidence of newly diagnosed dementia in hypertensive patients.