Teodoro J Oscanoa, Jose Amado, Xavier Vidal and Roman Romero-Ortuno
Universidad de San Martin de Porres, Peru
Hospital Almenara - EsSalud, Peru
Universidad Nacional Mayor de San Marcos, Peru
Vall d’Hebron Hospital, Barcelona, Spain
Trinity College Dublin, Discipline of Medical Gerontology, Mercer’s Institute for Successful Ageing, St James’s Hospital, Ireland
Posters & Accepted Abstracts: J Neurol Neurophysiol
Statement of the Problem: Antihypertensive medications may reduce the incidence of cognitive disorders. This may be due to
reasons beyond their pure hypotensive effect and could be different between antihypertensive classes. In this regard, angiotensinreceptor
blockers (ARBs) have attracted scientific interest. The aim of the present study was to conduct a systematic review and metaanalysis
of the reported association between the use of ARBs and the incidence of Alzheimer’s disease (AD).
Methodology: We systematically searched studies in PubMed, Cochrane Library and Google Scholar, since 1995 (date of approval
of the first ARB by FDA) up to November 2018. We included randomized controlled trials (RCTs) or observational studies reporting
the association between ARB use and incidence of AD in adults aged >18 years. The quality of studies was appraised according to the
Newcastle-Ottawa Quality Assessment Scale (NOS).
Findings: Nine studies (1 RCT, 2 case-control studies and 6 cohort studies) met the inclusion criteria (total number of participants:
923,906; mean age 70.8 (range: 57.6-82.4) years; mean follow-up 7.5 (range: 4-20) years; mean NOS 7.4. When all studies were
analyzed, ARB use was associated with a reduced risk of incident AD (HR 0.64, 95% CI 0.50-0.81, p <0.001). In the 4 studies reporting
a mean participants’ age of >75 years (n= 856,506), the reduction in AD risk seemed greater (HR 0.52, 95% CI 0.34-0.80, p <0.001);
in the 4 studies where mean age was <75 years (n=67,251), the risk reduction did not seem significant (HR 0.76, 95% CI 0.48-1.21, p=
0.250). The risk reduction seemed greater in European studies (n= 41,192; HR 0.56, 95% CI 0.41-0.77, p <0.001) than in American
(n= 821,712; HR 0.52, 95% CI 0.26-1.01, p= 0.054) or Asian (n= 61,002; HR 0.74, 95% CI 0.43-1.28, p= 0.285) studies.
Conclusion & Significance: ARB use may reduce the risk of incident AD, especially in Europeans aged >75 years. This association
does not imply causation and further research is required to clarify potential mechanisms.
References:
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Teodoro J Oscanoa PhD leads the Research Center of Drug Safety in The Faculty of Medicine at University of San Martin de Porres, Lima, Peru. He is the head of the Department of Internal Medicine at Hospital Almenara and Associate Professor of Pharmacology in Universidad Nacional Mayor de San Marcos in Lima. His research areas are Geriatric Pharmacology, Drug Safety and Pharmacogenetics.
E-mail: toscanoae@usmp.pe
