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No clear relationship between antihypertensive class and cognitive function over 12 months in a cohort study of community-dwelling adults aged 80 and over

BACKGROUND: Hypertension is prevalent in older adults. Hypertension has also been associated with an increased risk of cognitive decline. However, evidence relating to the impact of antihypertensive use is mixed. Calcium-channel blockers (CCB) have been suggested as the most beneficial class of anti...

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Autor principal: Peters, Ruth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357296/
https://www.ncbi.nlm.nih.gov/pubmed/30728929
http://dx.doi.org/10.1177/2040622318820849
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author Peters, Ruth
author_facet Peters, Ruth
author_sort Peters, Ruth
collection PubMed
description BACKGROUND: Hypertension is prevalent in older adults. Hypertension has also been associated with an increased risk of cognitive decline. However, evidence relating to the impact of antihypertensive use is mixed. Calcium-channel blockers (CCB) have been suggested as the most beneficial class of antihypertensive for protection of cognition in older adults, however, to date, there have been no cohort studies designed to examine this. METHODS: Community-dwelling treated hypertensive adults aged 80 and over were recruited from general practice sites and followed for 1 year. Cognitive function was assessed at baseline and 12 months using the modified Mini-Mental State Exam (3MS). Regression was used to examine the association between 12-month exposure to antihypertensive class and change in cognitive function. RESULTS: A total of 292 participants completed the study. Mean change in 3MS score was a rise of 0.53 [standard deviation (SD) 4.7] 3MS points in those taking CCBs (n = 135) compared with a drop of 0.09 (SD 5.1) in those without (n = 157) p = 0.28. There was no relationship between CCBs or between any antihypertensive class and change in cognitive function over 1 year. Additional analyses using a clinically meaningful fall of 5 or more 3MS points showed similar results. CONCLUSION: In a hypertensive community-dwelling older adult population treated with antihypertensives, there was no evidence that CCBs were protective of cognitive function over a 12-month exposure. If a protective effect is present, it may be small or require a longer treatment period. Larger longer studies are required for confirmation.
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spelling pubmed-63572962019-02-06 No clear relationship between antihypertensive class and cognitive function over 12 months in a cohort study of community-dwelling adults aged 80 and over Peters, Ruth Ther Adv Chronic Dis Original Research BACKGROUND: Hypertension is prevalent in older adults. Hypertension has also been associated with an increased risk of cognitive decline. However, evidence relating to the impact of antihypertensive use is mixed. Calcium-channel blockers (CCB) have been suggested as the most beneficial class of antihypertensive for protection of cognition in older adults, however, to date, there have been no cohort studies designed to examine this. METHODS: Community-dwelling treated hypertensive adults aged 80 and over were recruited from general practice sites and followed for 1 year. Cognitive function was assessed at baseline and 12 months using the modified Mini-Mental State Exam (3MS). Regression was used to examine the association between 12-month exposure to antihypertensive class and change in cognitive function. RESULTS: A total of 292 participants completed the study. Mean change in 3MS score was a rise of 0.53 [standard deviation (SD) 4.7] 3MS points in those taking CCBs (n = 135) compared with a drop of 0.09 (SD 5.1) in those without (n = 157) p = 0.28. There was no relationship between CCBs or between any antihypertensive class and change in cognitive function over 1 year. Additional analyses using a clinically meaningful fall of 5 or more 3MS points showed similar results. CONCLUSION: In a hypertensive community-dwelling older adult population treated with antihypertensives, there was no evidence that CCBs were protective of cognitive function over a 12-month exposure. If a protective effect is present, it may be small or require a longer treatment period. Larger longer studies are required for confirmation. SAGE Publications 2019-01-31 /pmc/articles/PMC6357296/ /pubmed/30728929 http://dx.doi.org/10.1177/2040622318820849 Text en © The Author(s), 2019 http://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 License (http://www.creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Peters, Ruth
No clear relationship between antihypertensive class and cognitive function over 12 months in a cohort study of community-dwelling adults aged 80 and over
title No clear relationship between antihypertensive class and cognitive function over 12 months in a cohort study of community-dwelling adults aged 80 and over
title_full No clear relationship between antihypertensive class and cognitive function over 12 months in a cohort study of community-dwelling adults aged 80 and over
title_fullStr No clear relationship between antihypertensive class and cognitive function over 12 months in a cohort study of community-dwelling adults aged 80 and over
title_full_unstemmed No clear relationship between antihypertensive class and cognitive function over 12 months in a cohort study of community-dwelling adults aged 80 and over
title_short No clear relationship between antihypertensive class and cognitive function over 12 months in a cohort study of community-dwelling adults aged 80 and over
title_sort no clear relationship between antihypertensive class and cognitive function over 12 months in a cohort study of community-dwelling adults aged 80 and over
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357296/
https://www.ncbi.nlm.nih.gov/pubmed/30728929
http://dx.doi.org/10.1177/2040622318820849
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