A2 Review article, Literature review, Systematic review
An investigation of antihypertensive class, dementia, and cognitive decline : A meta-analysis (2020)

Peters, R., Yasar, S., Anderson, C. S., Andrews, S., Antikainen, R., Arima, H., Beckett, N., Beer, J. C., Bertens, A. S., Booth, A., van Boxtel, M., Brayne, C., Brodaty, H., Carlson, M. C., Chalmers, J., Corrada, M., DeKosky, S., Derby, C., Dixon, R. A., . . . Anstey, K. J. (2020). An investigation of antihypertensive class, dementia, and cognitive decline : A meta-analysis. Neurology, 94(3), e267-e281. https://doi.org/10.1212/WNL.0000000000008732

JYU authors or editors

Publication details

All authors or editors: Peters, Ruth; Yasar, Sevil; Anderson, Craig S.; Andrews, Shea; Antikainen, Riitta; Arima, Hisatomi; Beckett, Nigel; Beer, Joanne C.; Bertens, Anne Suzanne; Booth, Andrew; et al.

Journal or series: Neurology

ISSN: 0028-3878

eISSN: 1526-632X

Publication year: 2020

Volume: 94

Issue number: 3

Pages range: e267-e281

Publisher: American Academy of Neurology

Publication country: United States

Publication language: English

DOI: https://doi.org/10.1212/WNL.0000000000008732

Publication open access: Not open

Publication channel open access:

Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/68396


High blood pressure is one of the main modifiable risk factors for dementia. However, there is conflicting evidence regarding the best antihypertensive class for optimizing cognition. Our objective was to determine whether any particular antihypertensive class was associated with a reduced risk of cognitive decline or dementia using comprehensive meta-analysis including reanalysis of original participant data.
To identify suitable studies, MEDLINE, Embase, and PsycINFO and preexisting study consortia were searched from inception to December 2017. Authors of prospective longitudinal human studies or trials of antihypertensives were contacted for data sharing and collaboration. Outcome measures were incident dementia or incident cognitive decline (classified using the reliable change index method). Data were separated into mid and late-life (>65 years) and each antihypertensive class was compared to no treatment and to treatment with other antihypertensives. Meta-analysis was used to synthesize data.
Over 50,000 participants from 27 studies were included. Among those aged >65 years, with the exception of diuretics, we found no relationship by class with incident cognitive decline or dementia. Diuretic use was suggestive of benefit in some analyses but results were not consistent across follow-up time, comparator group, and outcome. Limited data precluded meaningful analyses in those ≤65 years of age.
Our findings, drawn from the current evidence base, support clinical freedom in the selection of antihypertensive regimens to achieve blood pressure goals.

Keywords: hypertension; treatment methods; dementia; meta-analysis

Contributing organizations

Ministry reporting: Yes

Reporting Year: 2020

JUFO rating: 3

Last updated on 2022-20-09 at 13:52