Antihypertensive Therapy may Slow Cognitive Decline

As published in Nature, therapy for hypertension resulted in lessened rate of cognitive decline in 321 subjects studied in France - a result that was not expected in the hypothesis. The following is the abstract for the same.

Effects of Antihypertensive Therapy on Cognitive Decline in Alzheimer's Disease

Emmanuelle Duron¹, Anne-Sophie Rigaud¹, Delphine Dubail¹, Shima Mehrabian¹, Florence Latour¹, Marie-Laure Seux¹ and Olivier Hanon¹

¹Department of Geriatrics, University Descartes- Paris 5, Broca Hospital, Paris, France

Correspondence: E. Duron, (emmanuelle.duron@brc.aphp.fr)

Received 24 September 2008; First Decision 6 November 2008; Accepted 3 June 2009; Published online 9 July 2009.

Abstract

Background

Therapeutic trials concerning the effect of antihypertensive therapy on cognition have produced controversial findings. Our objective was to evaluate the impact of antihypertensive therapy on the cognitive function in subjects already diagnosed with Alzheimer's disease (AD).

Methods

We conducted an observational study in a memory clinic assessing outpatients suffering from AD. A total of 321 patients were included. Cognitive function was assessed yearly by the Mini-Mental State Examination (MMSE; score/30).

Results

The mean age of patients was 78.1  6 years, 54% of them received antihypertensive therapy and the mean MMSE scores were similar in both groups (patients taking antihypertensive therapy and patient without antihypertensive therapy). The mean follow-up was 34.1  6 months. MMSE means were significantly higher among patients using antihypertensive therapy compared to those without antihypertensive therapy (MMSE scores = 21.9  4.9 vs. 21.2  5.1 at 1 year (P = 0.001); 20.8 5.5 vs. 19.4  5.7 at 2 years (P < 0.001); 19.0  6.7 vs. 17.5  6.4 at 3 years (P < 0.001)), after adjustment for age, gender, education level, systolic blood pressure (SBP), and diastolic blood pressure (DBP) at baseline, MMSE at baseline, coronary heart disease, statins, and antiplatelet agents' consumption. Furthermore, the use of antihypertensive therapy was associated with a lower estimated risk of cognitive decline (as defined by a decrease of at least one point in MMSE score over time) (hazard ratio = 0.61; 95% confidence interval = 0.45–0.81) after adjustment for the same factors.

Conclusions

These results suggest an association between antihypertensive therapy, a lower decrease in mean MMSE and a lower cognitive decline over time in AD.

American Journal of Hypertension 2009; doi:10.1038/ajh.2009.119