Antihypertensive medications and risk of Alzheimer's disease: Evidence for specific medication use

Abstract BACKGROUND Hypertension is a modifiable risk factor for Alzheimer's disease (AD). Specific antihypertensive classes may lower/increase AD risk by affecting the renin–angiotensin–aldosterone system. METHODS We investigated AD risk in relation to antihypertensive medications in a population‐based study of 33,714 incident AD cases and 897,872 controls from Medicare data. Multinomial logistic regression models were adjusted for age, sex, race/ethnicity, smoking probability, and health‐care use. We performed 3‐year exposure lagged, 90‐day continuous medication prescription, and proportion of days covered analyses. RESULTS Beneficiaries prescribed angiotensin receptor blockers (ARBs; odds ratios ORs 0.93, 95% confidence intervals CIs 0.91–0.95) or thiazides (OR 0.93, 95% CI 0.91–0.95) had an inverse association of developing incident AD, while beneficiaries taking angiotensin converting enzyme inhibitors (OR 1.08, 95% CI 1.06–1.11) had a positive association with developing incident AD. DISCUSSION ARB medications and thiazide diuretics may be the preferred antihypertensive in patients at risk of AD.