Use of Antihypertensives, Blood Pressure, and Estimated Risk of Dementia in Late Life An Individual Participant Data Meta-Analysis

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art_LENNON_Use_of_Antihypertensives_Blood_Pressure_and_Estimated_Risk_2023.PDF (1.3 MB)
Citações na Scopus
4
Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
AMER MEDICAL ASSOC
Autores
LENNON, Matthew J.
LAM, Ben Chun Pan
LIPNICKI, Darren M.
CRAWFORD, John D.
PETERS, Ruth
SCHUTTE, Aletta E.
BRODATY, Henry
THALAMUTHU, Anbupalam
RYDBERG-STERNER, Therese
NAJAR, Jenna
Citação
JAMA NETWORK OPEN, v.6, n.9, article ID e2333353, 18p, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
IMPORTANCE The utility of antihypertensives and ideal blood pressure (BP) for dementia prevention in late life remains unclear and highly contested. OBJECTIVES To assess the associations of hypertension history, antihypertensive use, and baseline measured BP in late life (age >60 years) with dementia and the moderating factors of age, sex, and racial group. DATA SOURCE AND STUDY SELECTION Longitudinal, population-based studies of aging participating in the Cohort Studies of Memory in an International Consortium (COSMIC) group were included. Participants were individuals without dementia at baseline aged 60 to 110 years and were based in 15 different countries (US, Brazil, Australia, China, Korea, Singapore, Central African Republic, Republic of Congo, Nigeria, Germany, Spain, Italy, France, Sweden, and Greece). DATA EXTRACTION AND SYNTHESIS Participants were grouped in 3 categories based on previous diagnosis of hypertension and baseline antihypertensive use: healthy controls, treated hypertension, and untreated hypertension. Baseline systolic BP (SBP) and diastolic BP (DBP) were treated as continuous variables. Reporting followed the Preferred Reporting Items for Systematic Review and Meta-Analyses of Individual Participant Data reporting guidelines. MAIN OUTCOMES AND MEASURES The key outcome was all-cause dementia. Mixed-effects Cox proportional hazards models were used to assess the associations between the exposures and the key outcome variable. The association between dementia and baseline BP was modeled using nonlinear natural splines. The main analysis was a partially adjusted Cox proportional hazards model controlling for age, age squared, sex, education, racial group, and a random effect for study. Sensitivity analyses included a fully adjusted analysis, a restricted analysis of those individuals with more than 5 years of follow-up data, and models examining the moderating factors of age, sex, and racial group. RESULTS The analysis included 17 studies with 34 519 community dwelling older adults (20 160 [58.4%] female) with a mean (SD) age of 72.5 (7.5) years and a mean (SD) follow-up of 4.3 (4.3) years. In the main, partially adjusted analysis including 14 studies, individuals with untreated hypertension had a 42% increased risk of dementia compared with healthy controls (hazard ratio [HR], 1.42; 95% CI 1.15-1.76; P =.001) and 26% increased risk compared with individuals with treated hypertension (HR, 1.26; 95% CI, 1.03-1.53; P =.02). Individuals with treated hypertension had no significant increased dementia risk compared with healthy controls (HR, 1.13; 95% CI, 0.99-1.28; P =.07). The association of antihypertensive use or hypertension status with dementia did not vary with baseline BP. There was no significant association of baseline SBP or DBP with dementia risk in any of the analyses. There were no significant interactions with age, sex, or racial group for any of the analyses. CONCLUSIONS AND RELEVANCE This individual patient data meta-analysis of longitudinal cohort studies found that antihypertensive usewas associated with decreased dementia risk compared with individuals with untreated hypertension through all ages in late life. Individuals with treated hypertension had no increased risk of dementia compared with healthy controls.
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URI
https://observatorio.fm.usp.br/handle/OPI/57729
Referências
  1. Adesuyan M, 2022, JPAD-J PREV ALZHEIM, V9, P715, DOI 10.14283/jpad.2022.77
  2. Akushevich I, 2022, AM J HYPERTENS, V35, P745, DOI 10.1093/ajh/hpac063
  3. Anstey KJ, 2012, INT J EPIDEMIOL, V41, P951, DOI 10.1093/ije/dyr025
  4. Blanken AE, 2020, J ALZHEIMERS DIS, V78, P23, DOI 10.3233/JAD-200245
  5. Bloch MJ, 2016, J AM SOC HYPERTENS, V10, P753, DOI 10.1016/j.jash.2016.08.006
  6. Bress AP, 2016, J AM COLL CARDIOL, V67, P463, DOI 10.1016/j.jacc.2015.10.037
  7. Burke DL, 2017, STAT MED, V36, P855, DOI 10.1002/sim.7141
  8. Carey RM, 2018, J Am Coll Cardiol, V71, pe13, DOI [10.1016/j.jacc.2017.11.006, 10.1161/HYP.0000000000000066, DOI 10.1016/J.JACC.2017.11.006, 10.1161/HYP.0000000000000065, DOI 10.1161/HYP.0000000000000065]
  9. Dardiotis E, 2014, NEUROEPIDEMIOLOGY, V43, P9, DOI 10.1159/000362723
  10. Del Giorno R, 2019, MEDICINE, V98, DOI 10.1097/MD.0000000000016347
  11. Ding J, 2020, LANCET NEUROL, V19, P61, DOI 10.1016/S1474-4422(19)30393-X
  12. Ernst ME, 2020, HYPERTENSION, V76, P1945, DOI 10.1161/HYPERTENSIONAHA.120.16209
  13. Feng L, 2010, J NUTR HEALTH AGING, V14, P433
  14. Forte G, 2020, J CLIN MED, V9, DOI 10.3390/jcm9010034
  15. Gabin JM, 2017, ALZHEIMERS RES THER, V9, DOI 10.1186/s13195-017-0262-x
  16. Gao S, 1998, ARCH GEN PSYCHIAT, V55, P809, DOI 10.1001/archpsyc.55.9.809
  17. Guaita A, 2013, BMC GERIATR, V13, DOI 10.1186/1471-2318-13-98
  18. Guan JW, 2011, J ALZHEIMERS DIS, V27, P799, DOI 10.3233/JAD-2011-111160
  19. Guerchet M, 2014, SPRINGERPLUS, V3, DOI 10.1186/2193-1801-3-338
  20. Haan MN, 2003, J AM GERIATR SOC, V51, P169, DOI 10.1046/j.1532-5415.2003.51054.x
  21. Hall K, 1998, AUST NZ J PSYCHIAT, V32, P698, DOI 10.3109/00048679809113126
  22. Han JW, 2018, PSYCHIAT INVEST, V15, P767, DOI 10.30773/pi.2018.06.02
  23. Hassing LB, 2004, AGE AGEING, V33, P355, DOI 10.1093/ageing/afh100
  24. Hayden KM, 2006, ALZ DIS ASSOC DIS, V20, P93, DOI 10.1097/01.wad.0000213814.43047.86
  25. Hebert LE, 2004, NEUROLOGY, V62, P2021, DOI 10.1212/01.WNL.0000129258.93137.4B
  26. Hendrie HC, 2001, JAMA-J AM MED ASSOC, V285, P739, DOI 10.1001/jama.285.6.739
  27. Hughes D, 2020, JAMA-J AM MED ASSOC, V323, P1934, DOI 10.1001/jama.2020.4249
  28. Insel KC, 2005, EXP AGING RES, V31, P35, DOI 10.1080/03610730590882837
  29. Israeli-Korn SD, 2010, NEUROEPIDEMIOLOGY, V34, P99, DOI 10.1159/000264828
  30. Jefferson AL, 2018, CIRCULATION, V138, P1951, DOI 10.1161/CIRCULATIONAHA.118.032410
  31. Joas E, 2012, HYPERTENSION, V59, P796, DOI 10.1161/HYPERTENSIONAHA.111.182204
  32. Katz MJ, 2012, ALZ DIS ASSOC DIS, V26, P335, DOI 10.1097/WAD.0b013e31823dbcfc
  33. Kimm H, 2011, ARCH GERONTOL GERIAT, V52, pE117, DOI 10.1016/j.archger.2010.09.004
  34. Kuo HK, 2005, J AM GERIATR SOC, V53, P1154, DOI 10.1111/j.1532-5415.2005.53368.x
  35. Lennon MJ, 2019, J ALZHEIMERS DIS, V71, P307, DOI 10.3233/JAD-190474
  36. Levine DA, 2020, JAMA NEUROL, V77, P810, DOI 10.1001/jamaneurol.2020.0568
  37. Levine DA, 2019, HYPERTENSION, V73, P310, DOI 10.1161/HYPERTENSIONAHA.118.12062
  38. Li G, 2007, J AM GERIATR SOC, V55, P1161, DOI 10.1111/j.1532-5415.2007.01233.x
  39. Lindsay J, 2002, AM J EPIDEMIOL, V156, P445, DOI 10.1093/aje/kwf074
  40. Lipnicki DM, 2019, PLOS MED, V16, DOI 10.1371/journal.pmed.1002853
  41. Livingston G, 2020, LANCET, V396, P413, DOI 10.1016/S0140-6736(20)30367-6
  42. Lobo A, 2005, EUR J PSYCHIAT, V19, P31
  43. Mario B, 2009, INT J GERIATR PSYCH, V24, P509, DOI 10.1002/gps.2145
  44. Mewton L, 2023, ADDICTION, V118, P412, DOI 10.1111/add.16035
  45. Miller TA, 2016, PATIENT EDUC COUNS, V99, P1079, DOI 10.1016/j.pec.2016.01.020
  46. Mital R, 2021, J AM COLL CARDIOL, V78, P2483, DOI 10.1016/j.jacc.2021.05.051
  47. O'Neal WT, 2019, PLOS ONE, V14, DOI 10.1371/journal.pone.0222147
  48. Ou YN, 2020, HYPERTENSION, V76, P217, DOI 10.1161/HYPERTENSIONAHA.120.14993
  49. Peters R, 2022, EUR HEART J, V43, P4980, DOI 10.1093/eurheartj/ehac584
  50. Peters R, 2020, BRIT J PSYCHIAT, V216, P16, DOI 10.1192/bjp.2019.156
  51. Picone DS, 2020, HYPERTENSION, V75, P844, DOI 10.1161/HYPERTENSIONAHA.119.13973
  52. Pioli MR, 2018, INTEGR BLOOD PRESS C, V11, P73, DOI 10.2147/IBPC.S152761
  53. Power MC, 2011, EPIDEMIOLOGY, V22, P646, DOI 10.1097/EDE.0b013e31822708b5
  54. Qiu CX, 2004, STROKE, V35, P1810, DOI 10.1161/01.STR.0000133128.42462.ef
  55. Rajan KB, 2018, ANN NEUROL, V83, P935, DOI 10.1002/ana.25228
  56. Riedel-Heller SG, 2001, BRIT J PSYCHIAT, V179, P255, DOI 10.1192/bjp.179.3.255
  57. Ritchie K, 2010, BRIT MED J, V341, DOI 10.1136/bmj.c3885
  58. Ruitenberg A, 2001, DEMENT GERIATR COGN, V12, P33, DOI 10.1159/000051233
  59. Sachdev PS, 2010, INT PSYCHOGERIATR, V22, P1248, DOI 10.1017/S1041610210001067
  60. Sachdev PS, 2013, BMC NEUROL, V13, DOI 10.1186/1471-2377-13-165
  61. Samtani S, 2022, LANCET HEALTH LONGEV, V3, pE740, DOI 10.1016/S2666-7568(22)00199-4
  62. Scazufca M, 2008, INT J EPIDEMIOL, V37, P879, DOI 10.1093/ije/dyn125
  63. Schutte AE, 2022, NAT REV CARDIOL, V19, P643, DOI 10.1038/s41569-022-00690-0
  64. Shah NS, 2022, CIRCULATION, V146, P201, DOI 10.1161/CIRCULATIONAHA.121.058311
  65. Sheppard JP, 2020, J AM GERIATR SOC, V68, P2508, DOI 10.1111/jgs.16749
  66. Skoog I, 1996, LANCET, V347, P1141, DOI 10.1016/S0140-6736(96)90608-X
  67. Sterner TR, 2019, EUR J EPIDEMIOL, V34, P191, DOI 10.1007/s10654-018-0459-8
  68. Stewart LA, 2015, JAMA-J AM MED ASSOC, V313, P1657, DOI 10.1001/jama.2015.3656
  69. Stewart R, 2009, HYPERTENSION, V54, P233, DOI 10.1161/HYPERTENSIONAHA.109.128744
  70. Therneau TM., Package 'coxme'
  71. van Dalen JW, 2022, JAMA INTERN MED, V182, P142, DOI 10.1001/jamainternmed.2021.7009
  72. Walker KA, 2019, JAMA-J AM MED ASSOC, V322, P535, DOI 10.1001/jama.2019.10575
  73. Wang N, 2023, HYPERTENSION, V80, P608, DOI 10.1161/HYPERTENSIONAHA.122.20458
  74. Xiao SF, 2016, J MENT HEALTH, V25, P131, DOI 10.3109/09638237.2015.1124385
  75. Xu W, 2015, J NEUROL NEUROSUR PS, V86, P1299, DOI 10.1136/jnnp-2015-310548

Coleções
Artigos e Materiais de Revistas Científicas - HC/IPq
Artigos e Materiais de Revistas Científicas - LIM/23
Artigos e Materiais de Revistas Científicas - ODS/03
Artigos e Materiais de Revistas Científicas - ODS/05