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WHICH CARDIOVASCULAR DRUGS MAY HELP LOWER DEMENTIA RISK?


Written by Jessica Freeborn on November 29, 2024 — Fact checked by Amanda Ward
Share on PinterestWhich cardiovascular drugs may help prevent, and which may
increase the risk of dementia? Image credit: VICTOR TORRES/Stocksy.
 * Dementia prevention is a critical area of research, as experts want to
   understand what people can do to decrease dementia risk.
 * A recent study found that more than 5 years of taking medications like blood
   pressure and lipid-lowering drugs was associated with a lower incidence of
   dementia.
 * At the same time, researchers found that taking certain antiplatelet
   medications was associated with an increase in dementia diagnoses.



Multiple factors can contribute to someone’s odds of developing dementia, but
there are numerous protective factors as well. One particular area of interest
is the relationshipTrusted Source between cardiovascular disease and dementia.

A study recently published in the journal Alzheimer’s & DementiaTrusted Source
examined the relationship between certain cardiovascular disease medications and
the risk for dementia.

The study analyzed data from over 88,000 people with dementia and over 880,000
control participants who were dementia-free.

Researchers found that taking certain commonly prescribed drugs for 5 years or
more was associated with a decreased risk of dementia. These drugs included:

 * antihypertensives — drugs that treat high blood pressure
 * lipid-lowering medications — drugs that treat high cholesterol
 * diuretics — drugs that stimulate the elimination of excess salt and water
   through urine
 * oral anticoagulants — drugs that prevent blood clots from forming.

Combining antihypertensives with lipid-lowering medications, diuretics, or oral
anticoagulants for 5 years or more was also associated with a reduced risk.

In contrast, use of some antiplatelet medications — also a type of blood
thinners — was associated with an increased risk for dementia.

As research moves forward, experts may be able to figure out how to best use
these medications to improve dementia outcomes.


DO DRUGS FOR CARDIOVASCULAR DISEASE LOWER DEMENTIA RISK?

The study authors wanted to understand more about how the combination and
long-term use of cardiovascular medications affected dementia risk in a more
generalized population.

They collected information from the Swedish population via population registers.
They used the National Patient Register to identify dementia cases and included
88,065 participants with dementia.

The researchers then matched each dementia participant to 10 controls based on
age and sex.

Then, they used data from the Prescribed Drug Register to examine participants’
medications. They specifically looked at the use of:

 * oral anticoagulant drugs
 * diuretics
 * lipid-lowering drugs
 * antiplatelets, which prevent blood clots by affecting platelets
 * beta-blockers, calcium channel blockers, and renin-angiotensin system-acting
   agents, which all help lower blood pressure.

They also examined the combination use of these medications. They then divided
participants into four groups in terms of medication use: nonusers, users for 1
to 4 years, users for 5 to 9 years, and users for 10 years or more.

The study authors considered participants as exposed to a medication if they
picked up the prescription at least twice in one year. They noted that a
participant had to have been exposed to a medication for at least 4 years before
dementia diagnosis to account for the lag in dementia diagnosis.

Next, researchers used the Total Population Register and National Patient
Register to account for covariates like education level, history of numerous
cardiovascular problems, history of diabetes, and socioeconomic status.

Based on their analyses, they found that many of the examined medications
decreased the risk of dementia if taken for 5 years or longer. They found this
true for antihypertensives, lipid-lowering drugs, oral anticoagulants, and
diuretics.

However, they found that short-term use of 1 to 4 years of all cardiovascular
medication classes was associated with an increased risk for dementia.

The use of antiplatelet medications for any length of time was associated with
an increased risk for dementia.

In sensitivity analyses, researchers found that 10 years or more of antiplatelet
use was associated with a slight decrease in risk for dementia. However, this
result did not reach a level of statistical significance.

DOES COMBINING CARDIOVASCULAR DRUGS AFFECT BRAIN HEALTH?

Researchers next looked at the combination use of cardiovascular drugs. In these
analyses, they excluded participants who took cardiovascular medications for 4
years or less, and any participants using additional medications that were not
the focus of the research.

They found that combinations of antihypertensives and combinations of one
antihypertensive or more with a diuretic were associated with a lower risk for
dementia.

Combining lipid-lowering drugs with one or more antihypertensive was associated
with decreased dementia risk. There were similar results for oral anticoagulants
combined with antihypertensives.

In the combination analyses, researchers did not find a statistically
significant lower risk for dementia associated with lipid-lowering drugs or oral
anticoagulants taken alone.

When antiplatelets were paired with at least one antihypertensive, there was no
risk association with dementia. When combined with two or more
antihypertensives, there was a decreased risk for dementia.


DO THESE FINDINGS APPLY TO EVERYONE?

The study does present with limitations. First, it was conducted in Sweden,
meaning there may be a need for more diversity with later studies and that the
results cannot be generalized to all populations.

It also cannot prove causation, and there is a risk of bias. The researchers
acknowledged that the data apply to people who live at least 4 years after
starting cardiovascular drugs, rather than individuals who became ill quickly.

It is also possible that researchers missed dementia diagnoses, particularly
since they did not have access to primary care data. This could have affected
the overall results.

Residual confounding is possible because of other factors, like missed
cardiovascular disease diagnoses.

Finally, researchers had to operate under certain assumptions for their
research, such as the assumption that participants were taking the medications
that they picked up and were prescribed. One author also declared a conflict of
interest.

Mimi Lee, MD, a vascular neurologist and clinical neurophysiologist at
MemorialCare Orange Coast Medical Center in Fountain Valley, CA, who was not
involved in this research offered the following words of caution regarding the
study to Medical News Today:

> “While the study suggests that heart medications might help protect against
> dementia by improving blood flow and brain health, it can’t prove cause and
> effect. It’s based on observational data, meaning other factors, like diet or
> lifestyle, could be influencing the results. Also, the study only includes
> people from Sweden, so it may not apply to other populations. It also didn’t
> include people with severe health problems, which could affect the findings.”

It may be helpful to look more at the potential increased dementia risk
associated with short-term use of certain medications, as there could be
confounding involved in these scenarios. Additional research will also be
helpful to look at the relationship between cardiovascular medications and
dementia subtypes.

Future research may see how this data could be applied to dementia treatment.
Study author Mozhu Ding, PhD, assistant professor with the Karolinska
Institutet, told MNT that “there is a lot more to be done.”

“For instance, there is ongoing research to investigate if certain
cardiovascular disease drugs have a direct effect in clearing the enzymes in the
brain that is associated with Alzheimer’s diseases, which can be promising for
identifying targets for new dementia treatment,” she explained.

CARDIOVASCULAR TREATMENTS AND DEMENTIA RISK: THE TAKEAWAYS

Overall, the data adds to understanding regarding cardiovascular disease drugs
and how they may affect dementia risk.

Patrick Kee, MD, PhD, a cardiologist with Vital Heart & Vein, who was not
involved in this study, noted the following clinical implications of the data:

> “This study contributes to our understanding of optimal blood pressure
> management, particularly in preventing dementia and reducing cardiovascular
> complications like coronary artery disease, peripheral artery disease, and
> renovascular disease. While it’s intriguing and surprising to find an
> association between antiplatelet monotherapy and incident dementia, it’s
> reassuring to know that antihypertensive therapy may mitigate this potential
> adverse effect. Moreover, this study reinforces the safety of lipid-lowering
> drugs, emphasizing that they don’t increase the risk of developing dementia.”

Another concern regarding clinical practice is the study’s findings regarding
antiplatelet use. While it does require more research, it may be essential to
consider in later clinical practice.

“Antiplatelets stood out as the single drug class that seems to be harmful for
cognition,” Ding noted. “Given the widespread use of antiplatelets, it will be
important to consider their potential negative cognitive effect when prescribed
to patients in need.”


 * Heart Disease
 * Alzheimer's / Dementia
 * Cardiovascular / Cardiology
 * Drugs

Share this article



Written by Jessica Freeborn on November 29, 2024 — Fact checked by Amanda Ward




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