Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers reduced dementia risk in patients with diabetes mellitus and hypertension

Yi-Chun Kuan, Kuang Wei Huang, Der Jen Yen, Chaur Jong Hu, Cheng Li Lin, Chia Hung Kao

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective The effects of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) on dementia risk in patients with type 2 diabetes mellitus (DM) and hypertension remain unknown. We investigated the effects of ACEIs and ARBs on dementia risk in patients with type 2 DM and hypertension. Methods We conducted a cohort study by using the Taiwan National Health Insurance Research Database. We included 2377 patients receiving ACEIs and 1780 patients receiving ARBs in the ACEI and ARB cohorts, respectively. We included a comparable number of patients not receiving ACEIs and ARBs as controls in the non-ACEI and non-ARB cohorts through propensity score matching. The effect of ACEIs and ARBs on dementia risk was estimated through multivariate Cox proportional hazard regression after adjustment for several confounding factors. Results During the 12-year follow-up period, compared with the non-ACEI cohort, all-cause dementia risk decreased by 26% in the ACEI cohort [hazard ratio (HR) = 0.74, 95% confidence interval (CI) = 0.56–0.96]. The all-cause dementia risk was nearly 40% lower in the ARB cohort than in the non-ARB cohort (HR = 0.60, 95% CI = 0.37–0.97). These drugs prevented the occurrence of vascular dementia (VD), however, this effect was nonsignificant for Alzheimer's dementia (AD). Treatment duration- and dosage-related protection effects on dementia occurrence were observed. Conclusions ACEIs and ARBs may effectively prevent all-cause dementia, particularly VD, in patients with type 2 DM and hypertension. Moreover, compared with ACEIs, ARBs appear to be more advantageous in dementia prevention.

Original languageEnglish
Pages (from-to)462-466
Number of pages5
JournalInternational Journal of Cardiology
Volume220
DOIs
Publication statusPublished - Oct 1 2016

Fingerprint

Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Dementia
Diabetes Mellitus
Hypertension
Type 2 Diabetes Mellitus
Vascular Dementia
Confidence Intervals
Propensity Score
National Health Programs
Enzyme Inhibitors
Taiwan
Alzheimer Disease
Cohort Studies
Databases
Research
Pharmaceutical Preparations

Keywords

  • Angiotensin II receptor blockers
  • Angiotensin-converting enzyme inhibitors
  • Dementia
  • Diabetes mellitus
  • Hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers reduced dementia risk in patients with diabetes mellitus and hypertension. / Kuan, Yi-Chun; Huang, Kuang Wei; Yen, Der Jen; Hu, Chaur Jong; Lin, Cheng Li; Kao, Chia Hung.

In: International Journal of Cardiology, Vol. 220, 01.10.2016, p. 462-466.

Research output: Contribution to journalArticle

@article{a7e524be3b6b4d6ea90e36118c6dbabc,
title = "Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers reduced dementia risk in patients with diabetes mellitus and hypertension",
abstract = "Objective The effects of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) on dementia risk in patients with type 2 diabetes mellitus (DM) and hypertension remain unknown. We investigated the effects of ACEIs and ARBs on dementia risk in patients with type 2 DM and hypertension. Methods We conducted a cohort study by using the Taiwan National Health Insurance Research Database. We included 2377 patients receiving ACEIs and 1780 patients receiving ARBs in the ACEI and ARB cohorts, respectively. We included a comparable number of patients not receiving ACEIs and ARBs as controls in the non-ACEI and non-ARB cohorts through propensity score matching. The effect of ACEIs and ARBs on dementia risk was estimated through multivariate Cox proportional hazard regression after adjustment for several confounding factors. Results During the 12-year follow-up period, compared with the non-ACEI cohort, all-cause dementia risk decreased by 26{\%} in the ACEI cohort [hazard ratio (HR) = 0.74, 95{\%} confidence interval (CI) = 0.56–0.96]. The all-cause dementia risk was nearly 40{\%} lower in the ARB cohort than in the non-ARB cohort (HR = 0.60, 95{\%} CI = 0.37–0.97). These drugs prevented the occurrence of vascular dementia (VD), however, this effect was nonsignificant for Alzheimer's dementia (AD). Treatment duration- and dosage-related protection effects on dementia occurrence were observed. Conclusions ACEIs and ARBs may effectively prevent all-cause dementia, particularly VD, in patients with type 2 DM and hypertension. Moreover, compared with ACEIs, ARBs appear to be more advantageous in dementia prevention.",
keywords = "Angiotensin II receptor blockers, Angiotensin-converting enzyme inhibitors, Dementia, Diabetes mellitus, Hypertension",
author = "Yi-Chun Kuan and Huang, {Kuang Wei} and Yen, {Der Jen} and Hu, {Chaur Jong} and Lin, {Cheng Li} and Kao, {Chia Hung}",
year = "2016",
month = "10",
day = "1",
doi = "10.1016/j.ijcard.2016.06.215",
language = "English",
volume = "220",
pages = "462--466",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers reduced dementia risk in patients with diabetes mellitus and hypertension

AU - Kuan, Yi-Chun

AU - Huang, Kuang Wei

AU - Yen, Der Jen

AU - Hu, Chaur Jong

AU - Lin, Cheng Li

AU - Kao, Chia Hung

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Objective The effects of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) on dementia risk in patients with type 2 diabetes mellitus (DM) and hypertension remain unknown. We investigated the effects of ACEIs and ARBs on dementia risk in patients with type 2 DM and hypertension. Methods We conducted a cohort study by using the Taiwan National Health Insurance Research Database. We included 2377 patients receiving ACEIs and 1780 patients receiving ARBs in the ACEI and ARB cohorts, respectively. We included a comparable number of patients not receiving ACEIs and ARBs as controls in the non-ACEI and non-ARB cohorts through propensity score matching. The effect of ACEIs and ARBs on dementia risk was estimated through multivariate Cox proportional hazard regression after adjustment for several confounding factors. Results During the 12-year follow-up period, compared with the non-ACEI cohort, all-cause dementia risk decreased by 26% in the ACEI cohort [hazard ratio (HR) = 0.74, 95% confidence interval (CI) = 0.56–0.96]. The all-cause dementia risk was nearly 40% lower in the ARB cohort than in the non-ARB cohort (HR = 0.60, 95% CI = 0.37–0.97). These drugs prevented the occurrence of vascular dementia (VD), however, this effect was nonsignificant for Alzheimer's dementia (AD). Treatment duration- and dosage-related protection effects on dementia occurrence were observed. Conclusions ACEIs and ARBs may effectively prevent all-cause dementia, particularly VD, in patients with type 2 DM and hypertension. Moreover, compared with ACEIs, ARBs appear to be more advantageous in dementia prevention.

AB - Objective The effects of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) on dementia risk in patients with type 2 diabetes mellitus (DM) and hypertension remain unknown. We investigated the effects of ACEIs and ARBs on dementia risk in patients with type 2 DM and hypertension. Methods We conducted a cohort study by using the Taiwan National Health Insurance Research Database. We included 2377 patients receiving ACEIs and 1780 patients receiving ARBs in the ACEI and ARB cohorts, respectively. We included a comparable number of patients not receiving ACEIs and ARBs as controls in the non-ACEI and non-ARB cohorts through propensity score matching. The effect of ACEIs and ARBs on dementia risk was estimated through multivariate Cox proportional hazard regression after adjustment for several confounding factors. Results During the 12-year follow-up period, compared with the non-ACEI cohort, all-cause dementia risk decreased by 26% in the ACEI cohort [hazard ratio (HR) = 0.74, 95% confidence interval (CI) = 0.56–0.96]. The all-cause dementia risk was nearly 40% lower in the ARB cohort than in the non-ARB cohort (HR = 0.60, 95% CI = 0.37–0.97). These drugs prevented the occurrence of vascular dementia (VD), however, this effect was nonsignificant for Alzheimer's dementia (AD). Treatment duration- and dosage-related protection effects on dementia occurrence were observed. Conclusions ACEIs and ARBs may effectively prevent all-cause dementia, particularly VD, in patients with type 2 DM and hypertension. Moreover, compared with ACEIs, ARBs appear to be more advantageous in dementia prevention.

KW - Angiotensin II receptor blockers

KW - Angiotensin-converting enzyme inhibitors

KW - Dementia

KW - Diabetes mellitus

KW - Hypertension

UR - http://www.scopus.com/inward/record.url?scp=84977549764&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84977549764&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2016.06.215

DO - 10.1016/j.ijcard.2016.06.215

M3 - Article

C2 - 27390970

AN - SCOPUS:84977549764

VL - 220

SP - 462

EP - 466

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -