Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
Relationship of antihypertensives with late-life cognitive decline and neuropathology.
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Sood Ajay, Capuano Ana Werneck, Mehta Rupal, Barnes Lisa Laverne, Bennett David Alan, Arvanitakis Zoe
Аннотация
INTRODUCTION: Antihypertensives (AHTs) are commonly used to treat high blood pressure and other conditions, but their associations with cognitive decline and common age-related neuropathologies are not well understood.
METHODS: More than 3300 participants from three harmonized community-based cohorts without baseline dementia were evaluated annually for changes in cognition and > 1800 participants were analyzed for post mortem neuropathology.
RESULTS: In a linear mixed effect model adjusted for age, sex, education, and race/ethnicity, AHT use was associated with higher baseline global cognition (p < 0.001) and slower decline (p = 0.002) in global cognition, episodic memory, and semantic memory (all p < 0.02) compared to non-use. In the autopsy group AHT use was associated with a lower tau tangle density (p = 0.004), but not with other neurodegenerative or cerebrovascular pathologies. These associations did not change after controlling for blood pressure or other comorbidities.
DISCUSSION: AHT use is associated with slower cognitive decline and lower tau pathology in late life.
HIGHLIGHTS: In this prospective study of > 3200 older, community-dwelling, persons followed for a mean of 8.6 years, those who used antihypertensive (AHT) medications during the study had slower cognitive decline, especially in episodic memory and semantic memory, compared to non-users. Among the > 1800 deceased and autopsied persons, AHT medication use was associated with fewer paired helical filament-positive tau tangles (a marker of Alzheimer's disease) but not with other neurodegenerative or cerebrovascular pathologies, compared to non-users. Based on observational data from a large dataset, AHT use in older persons was related to slower cognitive decline and less Alzheimer's disease pathology.
METHODS: More than 3300 participants from three harmonized community-based cohorts without baseline dementia were evaluated annually for changes in cognition and > 1800 participants were analyzed for post mortem neuropathology.
RESULTS: In a linear mixed effect model adjusted for age, sex, education, and race/ethnicity, AHT use was associated with higher baseline global cognition (p < 0.001) and slower decline (p = 0.002) in global cognition, episodic memory, and semantic memory (all p < 0.02) compared to non-use. In the autopsy group AHT use was associated with a lower tau tangle density (p = 0.004), but not with other neurodegenerative or cerebrovascular pathologies. These associations did not change after controlling for blood pressure or other comorbidities.
DISCUSSION: AHT use is associated with slower cognitive decline and lower tau pathology in late life.
HIGHLIGHTS: In this prospective study of > 3200 older, community-dwelling, persons followed for a mean of 8.6 years, those who used antihypertensive (AHT) medications during the study had slower cognitive decline, especially in episodic memory and semantic memory, compared to non-users. Among the > 1800 deceased and autopsied persons, AHT medication use was associated with fewer paired helical filament-positive tau tangles (a marker of Alzheimer's disease) but not with other neurodegenerative or cerebrovascular pathologies, compared to non-users. Based on observational data from a large dataset, AHT use in older persons was related to slower cognitive decline and less Alzheimer's disease pathology.