Treating hypertension is a good Alzheimer’s prevention strategy even for patients in their 80s, research suggests.
Older people with hypertension – whether it’s treated or not – have a significantly greater risk of non-Alzheimer dementia compared to healthy people, research suggests.
The Australian-led research found that people over 60 with treated hypertension had a 28% higher risk of non-Alzheimer dementia than healthy controls, while people with untreated hypertension had a 68% higher risk.
Participants with untreated hypertension had a 36% higher risk of Alzheimer dementia compared to healthy controls, and a 42% higher risk compared to people with treated hypertension, according to the Neurology meta-analysis including more than 31,000 people in 14 countries.
Lead author Dr Matthew Lennon said the association between antihypertensive medication and reduced Alzheimer’s risk continued in older patients, suggesting that antihypertensives should be part of Alzheimer’s prevention strategy in later life.
“Whereas GPs and physicians may have an instinct to deprescribe medications for chronic illnesses as patients progress through late life, our study indicates that there may be ongoing benefits for cognition and dementia risk even in the very elderly,” Dr Lennon told TMR.
“For those older people who look to have a happy, healthy, flourishing life it’s really important to regularly check and work to control your blood pressure,” said Dr Lennon, a dementia researcher with the University of NSW’s Centre for Health Brain Ageing.
Dr Lennon noted that the study was a meta-analysis of longitudinal, observational studies, not a randomised controlled trial.
“As such, interpretations of causality and recommendations for changes in management need to be cautious.
“These studies provide population-level results and clearly any decisions about individual therapy needs to be made by weighing the risks and benefits of antihypertensive medication for that individual.”
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But Dr Lennon said their results were consistent with randomised controlled trials and included participants that were older, more co-morbid and more racially diverse, so the results were “more generalisable”.
Subgroup analyses showed that men with treated hypertension had a 67% greater risk of non-Alzheimer’s dementia, while women had a 6% increased risk, compared to controls.
“This finding is consistent with previous research indicating that men are more susceptible to poststroke dementia than women,” the researchers said.
The researchers also found that baseline blood pressure did not change the association between hypertension or antihypertensive use and Alzheimer’s risk.
“This finding indicates that a single measure of baseline BP, being a cross-sectional snapshot of a highly variable biomarker, is of limited practical use when deciding to continue antihypertensive treatment for Alzheimer dementia risk reduction,” the researchers said.
“However, those with treated hypertension who had poorly controlled BP had significantly higher non-Alzheimer dementia risk than those with well-controlled BP.”
