Angiotensin-receptor blockers and risk of alzheimer's disease in hypertension population - A nationwide cohort study

Chien Yi Hsu, Chin Chou Huang, Wan Leong Chan, Po Hsun Huang, Chia Hung Chiang, Tzeng Ji Chen, Chia Min Chung, Shing Jong Lin, Jaw Wen Chen, Hsin Bang Leu

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background: Although emerging evidence shows angiotensin-receptor blockers (ARBs) may have a beneficial effect against Alzheimer's disease (AD), the association is not consistent. We investigated the association between ARB use and the risk of development of AD using a nationwide, population-based cohort database in Taiwan. Methods and Results: In total, 16,426 newly diagnosed hypertensive patients who were administered ARB without a previous diagnosis of AD were identified from the Taiwan National Health Insurance database. The comparison group consisted of hypertensive patients who did not receive ARB, and were matched to exposed individuals using propensity score by enrolled time, age, sex, and comorbidities. During an average of 5.24±2.01 years of follow-up, a total of 1,031 cases (3.13%) of new AD occurred. The log-rank test showed no significant difference in the AD occurrence rate between subjects exposed to ARBs and non-exposed controls [488 (2.97%) vs. 543 (3.29%), P=0.221]. After adjusting for age, sex, comorbidities, and medications, only advanced age [hazard ratio (HR) 1.12, 95% confidence interval (CI) 1.12-1.13, P<0.001), female sex (HR 1.18, 95% CI 1.04-1.33, P=0.011), diabetes (HR 1.53, 95% CI 1.31-1.79, P<0.001), but not ARB (HR 1.08, 95% CI 0.96-1.22, P=0.222) were independently associated with AD development. Conclusions: The use of ARB was not significantly associated with a reduction of risk of AD in Asian patients with essential hypertension.

Original languageEnglish
Pages (from-to)405-410
Number of pages6
JournalCirculation Journal
Volume77
Issue number2
DOIs
Publication statusPublished - Feb 4 2013
Externally publishedYes

Fingerprint

Angiotensin Receptor Antagonists
Alzheimer Disease
Cohort Studies
Hypertension
Population
Confidence Intervals
Taiwan
Comorbidity
Databases
Propensity Score
Sex Ratio
National Health Programs
Risk Reduction Behavior

Keywords

  • Alzheimer's disease
  • Angiotensin-receptor blockers
  • Dementia
  • Hypertension
  • Taiwan national health insurance research database

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Angiotensin-receptor blockers and risk of alzheimer's disease in hypertension population - A nationwide cohort study. / Hsu, Chien Yi; Huang, Chin Chou; Chan, Wan Leong; Huang, Po Hsun; Chiang, Chia Hung; Chen, Tzeng Ji; Chung, Chia Min; Lin, Shing Jong; Chen, Jaw Wen; Leu, Hsin Bang.

In: Circulation Journal, Vol. 77, No. 2, 04.02.2013, p. 405-410.

Research output: Contribution to journalArticle

Hsu, CY, Huang, CC, Chan, WL, Huang, PH, Chiang, CH, Chen, TJ, Chung, CM, Lin, SJ, Chen, JW & Leu, HB 2013, 'Angiotensin-receptor blockers and risk of alzheimer's disease in hypertension population - A nationwide cohort study', Circulation Journal, vol. 77, no. 2, pp. 405-410. https://doi.org/10.1253/circj.CJ-12-0658
Hsu, Chien Yi ; Huang, Chin Chou ; Chan, Wan Leong ; Huang, Po Hsun ; Chiang, Chia Hung ; Chen, Tzeng Ji ; Chung, Chia Min ; Lin, Shing Jong ; Chen, Jaw Wen ; Leu, Hsin Bang. / Angiotensin-receptor blockers and risk of alzheimer's disease in hypertension population - A nationwide cohort study. In: Circulation Journal. 2013 ; Vol. 77, No. 2. pp. 405-410.
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AU - Hsu, Chien Yi

AU - Huang, Chin Chou

AU - Chan, Wan Leong

AU - Huang, Po Hsun

AU - Chiang, Chia Hung

AU - Chen, Tzeng Ji

AU - Chung, Chia Min

AU - Lin, Shing Jong

AU - Chen, Jaw Wen

AU - Leu, Hsin Bang

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N2 - Background: Although emerging evidence shows angiotensin-receptor blockers (ARBs) may have a beneficial effect against Alzheimer's disease (AD), the association is not consistent. We investigated the association between ARB use and the risk of development of AD using a nationwide, population-based cohort database in Taiwan. Methods and Results: In total, 16,426 newly diagnosed hypertensive patients who were administered ARB without a previous diagnosis of AD were identified from the Taiwan National Health Insurance database. The comparison group consisted of hypertensive patients who did not receive ARB, and were matched to exposed individuals using propensity score by enrolled time, age, sex, and comorbidities. During an average of 5.24±2.01 years of follow-up, a total of 1,031 cases (3.13%) of new AD occurred. The log-rank test showed no significant difference in the AD occurrence rate between subjects exposed to ARBs and non-exposed controls [488 (2.97%) vs. 543 (3.29%), P=0.221]. After adjusting for age, sex, comorbidities, and medications, only advanced age [hazard ratio (HR) 1.12, 95% confidence interval (CI) 1.12-1.13, P<0.001), female sex (HR 1.18, 95% CI 1.04-1.33, P=0.011), diabetes (HR 1.53, 95% CI 1.31-1.79, P<0.001), but not ARB (HR 1.08, 95% CI 0.96-1.22, P=0.222) were independently associated with AD development. Conclusions: The use of ARB was not significantly associated with a reduction of risk of AD in Asian patients with essential hypertension.

AB - Background: Although emerging evidence shows angiotensin-receptor blockers (ARBs) may have a beneficial effect against Alzheimer's disease (AD), the association is not consistent. We investigated the association between ARB use and the risk of development of AD using a nationwide, population-based cohort database in Taiwan. Methods and Results: In total, 16,426 newly diagnosed hypertensive patients who were administered ARB without a previous diagnosis of AD were identified from the Taiwan National Health Insurance database. The comparison group consisted of hypertensive patients who did not receive ARB, and were matched to exposed individuals using propensity score by enrolled time, age, sex, and comorbidities. During an average of 5.24±2.01 years of follow-up, a total of 1,031 cases (3.13%) of new AD occurred. The log-rank test showed no significant difference in the AD occurrence rate between subjects exposed to ARBs and non-exposed controls [488 (2.97%) vs. 543 (3.29%), P=0.221]. After adjusting for age, sex, comorbidities, and medications, only advanced age [hazard ratio (HR) 1.12, 95% confidence interval (CI) 1.12-1.13, P<0.001), female sex (HR 1.18, 95% CI 1.04-1.33, P=0.011), diabetes (HR 1.53, 95% CI 1.31-1.79, P<0.001), but not ARB (HR 1.08, 95% CI 0.96-1.22, P=0.222) were independently associated with AD development. Conclusions: The use of ARB was not significantly associated with a reduction of risk of AD in Asian patients with essential hypertension.

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