Effects of Antihypertensive Therapy on Cognitive Decline in Alzheimer's Disease

• Published in: American journal of hypertension Vol. 22; no. 9; pp. 1020 - 1024
• Main Authors: Duron, Emmanuelle, Rigaud, Anne-Sophie, Dubail, Delphine, Mehrabian, Shima, Latour, Florence, Seux, Marie-Laure, Hanon, Olivier
• Format: Journal Article
• Language: English
• Published: Basingstoke Oxford University Press 01.09.2009; Nature Publishing Group
• Subjects: Aged; Aged, 80 and over; Alzheimer Disease - complications; Alzheimer Disease - drug therapy; Antihypertensive agents; Antihypertensive Agents - therapeutic use; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular system; Cognition - drug effects; Cognition Disorders - complications; Cognition Disorders - drug therapy; Female; Humans; Male; Medical sciences; Neuropsychological Tests; Pharmacology. Drug treatments; Hypertension; Nervous system diseases; Treatment; Alzheimer disease; Central nervous system disease; Antihypertensive agent; Cardiovascular disease; Degenerative disease; Cerebral disorder
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1038/ajh.2009.119

Background Therapeutic trials concerning the effect of antihypertensive therapy on cognition have produced controversial findings. Our objective was to evaluate the impact of antihypertensive therapy on the cognitive function in subjects already diagnosed with Alzheimer's disease (AD). Methods We conducted an observational study in a memory clinic assessing outpatients suffering from AD. A total of 321 patients were included. Cognitive function was assessed yearly by the Mini-Mental State Examination (MMSE; score/30). Results The mean age of patients was 78.1 ± 6 years, 54% of them received antihypertensive therapy and the mean MMSE scores were similar in both groups (patients taking antihypertensive therapy and patient without antihypertensive therapy). The mean follow-up was 34.1 ± 6 months. MMSE means were significantly higher among patients using antihypertensive therapy compared to those without antihypertensive therapy (MMSE scores = 21.9 ± 4.9 vs. 21.2 ± 5.1 at 1 year (P = 0.001); 20.8 ± 5.5 vs. 19.4 ± 5.7 at 2 years (P < 0.001); 19.0 ± 6.7 vs. 17.5 ± 6.4 at 3 years (P < 0.001)), after adjustment for age, gender, education level, systolic blood pressure (SBP), and diastolic blood pressure (DBP) at baseline, MMSE at baseline, coronary heart disease, statins, and antiplatelet agents' consumption. Furthermore, the use of antihypertensive therapy was associated with a lower estimated risk of cognitive decline (as defined by a decrease of at least one point in MMSE score over time) (hazard ratio = 0.61; 95% confidence interval = 0.45–0.81) after adjustment for the same factors. Conclusions These results suggest an association between antihypertensive therapy, a lower decrease in mean MMSE and a lower cognitive decline over time in AD.