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

Chih-Ying Lin; Pei-Hsien Chen; Chiu-Lin Tsai; Yow-Wen Hsieh; Kai-Chieh Hu; Fuu-Jen Tsai; Der-Yang Cho; Hsien-Yin Liao

doi:10.1016/j.jocn.2024.05.006

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

J Clin Neurosci. 2024 May 16:125:83-94. doi: 10.1016/j.jocn.2024.05.006. Online ahead of print.

Authors

Chih-Ying Lin¹, Pei-Hsien Chen², Chiu-Lin Tsai³, Yow-Wen Hsieh⁴, Kai-Chieh Hu⁵, Fuu-Jen Tsai⁶, Der-Yang Cho⁷, Hsien-Yin Liao⁸

Affiliations

¹ Department of Chinese Traumatology Medicine, China Medical University Hospital, Taichung 40402, Taiwan.
² Department of Chinese Medicine, China Medical University Hospital, Taichung 40402, Taiwan.
³ Department of Chinese Medicine Pharmacy, China Medical University Hospital, Taichung 40402, Taiwan.
⁴ Graduate Institute of Pharmacy, China Medical University, Taichung 40402, Taiwan; Department of Pharmacy, China Medical University Hospital, Taichung 40402, Taiwan.
⁵ Management Office for Health Data (Dry Lab), Clinical Trial Center, China Medical University Hospital, Taichung 40402, Taiwan.
⁶ School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung 40402, Taiwan; Division of Medical Genetics, China Medical University Children's Hospital, Taichung 40447, Taiwan; Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan.
⁷ Translational Cell Therapy Center, Department of Medical Research, China Medical University Hospital, Taichung 40447, Taiwan; Department of Neurosurgery, China Medical University Hospital, Taichung 40447, Taiwan; Graduate Institute of Biomedical Sciences, China Medical University, Taichung 40447, Taiwan.
⁸ School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan; Department of Acupuncture, China Medical University Hospital, Taichung 40402, Taiwan. Electronic address: jamesliao@mail.cmu.edu.tw.

PMID: 38759352
DOI: 10.1016/j.jocn.2024.05.006

Abstract

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.

Keywords: Alzheimer’s disease; Antihypertension medication; Dementia; Hypertension; traditional Chinese medicine.