Research published today on bmj.com reports that angiotensin receptor blockers are associated with a reduced risk of Alzheimer’s disease and dementia. These drugs are normally used to treat high blood pressure and heart disease.

In addition, the study concludes that angiotensin receptor blockers appear to offer greater protection against Alzheimer’s disease and dementia than other high blood pressure and heart disease medication.

A growing number of people are threatened by dementia (including Alzheimer’s disease) as they get older. This has important economic implications since individuals who suffer from either disease can spend long periods of time in nursing homes.

Dementia and Alzheimer’s disease are complex diseases. There is increasing evidence of three main risk factors:

• age
• genetics
• heart disease

Mid-life diseases particularly like diabetes and high blood pressure seem to be associated with a higher chance of developing dementia.

Researchers explain that this is the first large scale study to investigate whether angiotensin receptor blockers reduce the risk of developing dementia and Alzheimer’s disease.

Professor Benjamin Wolozin from Boston University School of Medicine led the team of researchers. They investigated the incidence of dementia in over 800,000 individuals in the US from 2002 to 2006. They were mostly (98 percent) male subjects. The participants had cardiovascular disease and were 65 years of age or older.

The research subjects were divided in three groups: one using angiotensin receptor blockers, another the blood pressure lowering drug lisinopril and the third using other comparative drugs used for heart disease.

The findings indicate that the group on angiotensin receptor blockers was significantly less likely to develop Alzheimer’s disease or dementia. In addition, they reveal that angiotensin receptor blockers have an additive effect when used in combination with another type of high blood pressure drug (ACE inhibitors). In fact, individuals with existing Alzheimer’s disease or dementia who took both medicines were less likely to die early or be admitted to nursing homes.

In conclusion, Wolozin comments that the research is significant because it is the “first to compare both risk of dementia and progression of dementia in users of angiotensin receptor blockers compared with users of a drug from the same class (lisinopril) or users of other drugs prescribed for cardiovascular disease.”

In an associated editorial, two senior doctors from the University of Calgary highlight that the public health implications of finding an effective way of preventing dementia are immense. They say in closing that however, further work is needed to verify the usefulness of antihypertensives in general and angiotensin receptor blockers in particular.

“Use of angiotensin receptor blockers and risk of dementia in a predominantly male population: prospective cohort analysis”
Nien-Chen Li, statistician, Austin Lee, senior statistician, Rachel A Whitmer, research epidemiologist,Miia Kivipelto, associate professor, Elizabeth Lawler, epidemiologist, Lewis E Kazis, professor,Benjamin Wolozin, professor
BMJ 2010; 340:b5465
doi:10.1136/bmj.b5465

“Antihypertensive agents and prevention of dementia”
Colleen J Maxwell, associate professor, David B Hogan, professor and Brenda Strafford Foundation chair in geriatric medicine
doi=10.1136/bmj.b5409
bmj.com

Written by Stephanie Brunner (B.A.)