Antihypertensive medication use and incident alzheimer disease: The cache county study

Ara S. Khachaturian, Peter P. Zandi, Constantine G. Lyketsos, Kathleen M. Hayden, Ingmar Skoog, Maria C. Norton, JoAnn T. Tschanz, Lawrence S. Mayer, Kathleen A. Welsh-Bohmer, John C S Breitner

Research output: Contribution to journalArticle

270 Citations (Scopus)

Abstract

Background: Recent reports suggest that antihypertensive (AH) medications may reduce the risk of dementing illnesses. Objectives: To examine the relationship of AH medication use with incidence of Alzheimer disease (AD) among the elderly population (aged 65 years and older) of Cache County, Utah, and to examine whether the relationship varies with different classes of AH medications. Methods: After an initial (wave 1) multistage assessment (1995 through 1997) to identify prevalent cases of dementia, we used similar methods 3 years later (wave 2) to identify 104 incident cases of AD among the 3308 survivors. At the baseline assessment, we obtained a detailed drug inventory from the study participants. We carried out discrete time survival analyses to examine the association between the use of AH medications (including angiotensin converting enzyme inhibitors, β-blockers, calcium channel blockers, and diuretics) at baseline with subsequent risk of AD. Results: Use of any AH medication at baseline was associated with lower incidence of AD (adjusted hazard ratio, 0.64; 95% confidence interval, 0.41-0.98). Examination of medication subclasses showed that use of diuretics (adjusted hazard ratio, 0.57; 95% confidence interval, 0.33-0.94), and specifically potassium-sparing diuretics (adjusted hazard ratio, 0.26; 95% confidence interval, 0.08-0.64), was associated with the greatest reduction in risk of AD. Corresponding analysis with a fully examined subsample controlling for blood pressure measurements did not substantially change our findings. Conclusions: These data suggest that AH medications, and specifically potassium-sparing diuretics, are associated with reduced incidence of AD. Because the latter association is a new finding, it requires confirmation in further study.

Original languageEnglish (US)
Pages (from-to)686-692
Number of pages7
JournalArchives of Neurology
Volume63
Issue number5
StatePublished - May 2006
Externally publishedYes

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Antihypertensive Agents
Alzheimer Disease
Potassium Sparing Diuretics
Confidence Intervals
Diuretics
Incidence
Calcium Channel Blockers
Risk Reduction Behavior
Survival Analysis
Angiotensin-Converting Enzyme Inhibitors
Dementia
Cache
Alzheimer's Disease
Medication
Blood Pressure
Equipment and Supplies
Pharmaceutical Preparations
Population
Confidence Interval
Hazard

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Khachaturian, A. S., Zandi, P. P., Lyketsos, C. G., Hayden, K. M., Skoog, I., Norton, M. C., ... Breitner, J. C. S. (2006). Antihypertensive medication use and incident alzheimer disease: The cache county study. Archives of Neurology, 63(5), 686-692.

Antihypertensive medication use and incident alzheimer disease : The cache county study. / Khachaturian, Ara S.; Zandi, Peter P.; Lyketsos, Constantine G.; Hayden, Kathleen M.; Skoog, Ingmar; Norton, Maria C.; Tschanz, JoAnn T.; Mayer, Lawrence S.; Welsh-Bohmer, Kathleen A.; Breitner, John C S.

In: Archives of Neurology, Vol. 63, No. 5, 05.2006, p. 686-692.

Research output: Contribution to journalArticle

Khachaturian, AS, Zandi, PP, Lyketsos, CG, Hayden, KM, Skoog, I, Norton, MC, Tschanz, JT, Mayer, LS, Welsh-Bohmer, KA & Breitner, JCS 2006, 'Antihypertensive medication use and incident alzheimer disease: The cache county study', Archives of Neurology, vol. 63, no. 5, pp. 686-692.
Khachaturian AS, Zandi PP, Lyketsos CG, Hayden KM, Skoog I, Norton MC et al. Antihypertensive medication use and incident alzheimer disease: The cache county study. Archives of Neurology. 2006 May;63(5):686-692.
Khachaturian, Ara S. ; Zandi, Peter P. ; Lyketsos, Constantine G. ; Hayden, Kathleen M. ; Skoog, Ingmar ; Norton, Maria C. ; Tschanz, JoAnn T. ; Mayer, Lawrence S. ; Welsh-Bohmer, Kathleen A. ; Breitner, John C S. / Antihypertensive medication use and incident alzheimer disease : The cache county study. In: Archives of Neurology. 2006 ; Vol. 63, No. 5. pp. 686-692.
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abstract = "Background: Recent reports suggest that antihypertensive (AH) medications may reduce the risk of dementing illnesses. Objectives: To examine the relationship of AH medication use with incidence of Alzheimer disease (AD) among the elderly population (aged 65 years and older) of Cache County, Utah, and to examine whether the relationship varies with different classes of AH medications. Methods: After an initial (wave 1) multistage assessment (1995 through 1997) to identify prevalent cases of dementia, we used similar methods 3 years later (wave 2) to identify 104 incident cases of AD among the 3308 survivors. At the baseline assessment, we obtained a detailed drug inventory from the study participants. We carried out discrete time survival analyses to examine the association between the use of AH medications (including angiotensin converting enzyme inhibitors, β-blockers, calcium channel blockers, and diuretics) at baseline with subsequent risk of AD. Results: Use of any AH medication at baseline was associated with lower incidence of AD (adjusted hazard ratio, 0.64; 95{\%} confidence interval, 0.41-0.98). Examination of medication subclasses showed that use of diuretics (adjusted hazard ratio, 0.57; 95{\%} confidence interval, 0.33-0.94), and specifically potassium-sparing diuretics (adjusted hazard ratio, 0.26; 95{\%} confidence interval, 0.08-0.64), was associated with the greatest reduction in risk of AD. Corresponding analysis with a fully examined subsample controlling for blood pressure measurements did not substantially change our findings. Conclusions: These data suggest that AH medications, and specifically potassium-sparing diuretics, are associated with reduced incidence of AD. Because the latter association is a new finding, it requires confirmation in further study.",
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AU - Lyketsos, Constantine G.

AU - Hayden, Kathleen M.

AU - Skoog, Ingmar

AU - Norton, Maria C.

AU - Tschanz, JoAnn T.

AU - Mayer, Lawrence S.

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AU - Breitner, John C S

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N2 - Background: Recent reports suggest that antihypertensive (AH) medications may reduce the risk of dementing illnesses. Objectives: To examine the relationship of AH medication use with incidence of Alzheimer disease (AD) among the elderly population (aged 65 years and older) of Cache County, Utah, and to examine whether the relationship varies with different classes of AH medications. Methods: After an initial (wave 1) multistage assessment (1995 through 1997) to identify prevalent cases of dementia, we used similar methods 3 years later (wave 2) to identify 104 incident cases of AD among the 3308 survivors. At the baseline assessment, we obtained a detailed drug inventory from the study participants. We carried out discrete time survival analyses to examine the association between the use of AH medications (including angiotensin converting enzyme inhibitors, β-blockers, calcium channel blockers, and diuretics) at baseline with subsequent risk of AD. Results: Use of any AH medication at baseline was associated with lower incidence of AD (adjusted hazard ratio, 0.64; 95% confidence interval, 0.41-0.98). Examination of medication subclasses showed that use of diuretics (adjusted hazard ratio, 0.57; 95% confidence interval, 0.33-0.94), and specifically potassium-sparing diuretics (adjusted hazard ratio, 0.26; 95% confidence interval, 0.08-0.64), was associated with the greatest reduction in risk of AD. Corresponding analysis with a fully examined subsample controlling for blood pressure measurements did not substantially change our findings. Conclusions: These data suggest that AH medications, and specifically potassium-sparing diuretics, are associated with reduced incidence of AD. Because the latter association is a new finding, it requires confirmation in further study.

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