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Hypertension therapy lowers risk of dementia

Hypertension therapy lowers risk of dementia


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Treat high blood pressure with medication and thereby avoid dementia

Hypertension is the number one common disease. According to experts, around one in three adults in Germany is affected. However, hypertension can be treated very well. Successful blood pressure therapy also reduces the risk of dementia.

It has long been known that people with chronically high blood pressure are more likely to develop dementia. Conversely, can this increased risk of dementia also be reduced by drug blood pressure therapy? A metanalysis came to the conclusion that the successful setting of medication for high blood pressure significantly reduces the risk of dementia.

Untreated hypertension increases the risk of dementia

Untreated high blood pressure (hypertension) damages the organs of the body. This affects so-called end organs like the kidney and the heart as well as the brain. The mental performance is impaired and the development of dementia is favored, as was shown years ago in scientific studies.

For example, researchers from the French National Institute of Health and Medical Research (Inserm) in Paris and University College London reported in the journal "European Heart Journal" that increased blood pressure in middle age can massively increase the risk of developing dementia.

As the Deutsche Gesellschaft für Neurologie eV (DGN) now reports in a communication, a current metanalysis now comes to the conclusion that the successful medication of hypertension reduces the risk of dementia by twelve percent and the risk of developing Alzheimer's by 16 Percent lowers.

Drug-lowering blood pressure reduces the risk of stroke and heart attack

DGN experts see great prevention potential in view of the high and increasing prevalence of dementia and the lack of treatment options.

There are currently around 1.2 million people living with dementia in Germany. An estimated 244,000 people are affected every year. Dementia can be the expression and consequence of various diseases such as Alzheimer's disease, Lewy body dementia or the result of vascular damage in the brain (for example after a stroke, one then speaks of vascular dementia).

According to the DGN's S3 guideline, around 50-70 percent of dementia patients are classified as Alzheimer's and around 15-25 percent of vascular dementia.

It has been shown that lowering drug blood pressure, for example, significantly reduces the risk of stroke and heart attack - but does it also have an effect on the dementia rate? And if so, which substance class of antihypertensives - ACE inhibitors, angiotensin II receptor blockers, beta blockers, calcium channel blockers or diuretics - is particularly effective in this regard?

These questions were examined in a meta-analysis published in the January issue of Lancet Neurology.

Positive and clinically relevant influence of high blood pressure control

According to the information provided, the present study evaluated six large cohorts of prospective observational studies with a total of just over 31,000 people without pre-existing dementia over the age of 55 - and stratified them in two groups:

One group included study participants who had normal blood pressure values ​​(below 140/90 mm Hg) at the time of the study inclusion (n = 15,553), the others had elevated blood pressure values ​​(n = 15,537).

The proportion of participants receiving drug-lowering therapy varied in the six studies included in the analysis, ranging from 32.5 percent to 62.1 percent.

As a result, a total of 3,728 study participants developed new dementia during the observation period, 1,741 patients were Alzheimer's.

Comparing the disease rate of those with high blood pressure who took medication-lowering blood pressure to those who were untreated, after adjusting the data, it became clear that drug-related hypertension therapy protects against dementia:

Those who were treated for high blood pressure had a 12 percent lower risk of developing dementia and a 16 percent lower risk of Alzheimer's.

If there were previously contradictory data on the role of hypertension, this meta-analysis clearly shows a positive and clinically relevant influence of hypertension control.

Prevention potential should definitely be exploited

The DGN expert for dementia, Prof. Richard Dodel, sees great potential for prevention here: “Hypertension is an immense health problem in our population. Almost every second person over the age of 60 is affected and many patients are untreated or inadequate. ”

And further: “We now know that by lowering drug blood pressure, these people can not only reduce their risk of cardiovascular diseases, but also the risk of developing dementia later. This prevention potential should definitely be exploited, ultimately because we still have no disease-modifying therapy for dementia and the number of people suffering from it continues to increase. "

In addition, the evaluation showed that it did not matter which substance class the patients were treated with, none of the five different substance classes proved to be superior to the others in terms of risk reduction.

"So it is not the case that a certain class of antihypertensives has an 'anti-dementia effect', but that a successful lowering of the blood pressure to the target value range below 140/90 mm Hg leads to a reduction in the risk of dementia," said the expert.

Accordingly, the study participants with normal blood pressure values, who - for whatever reason - had taken hypotensive drugs, had no effect on the dementia rate.

“We neurologists cannot appeal enough that people with high blood pressure are treated consistently and that the hypotensive people regularly take them as prescribed. In this way, they protect themselves from two neurological "common diseases": stroke and dementia, "says Professor Dr. med. Hans-Christoph Diener, Essen, press spokesman for the DGN.

It would be interesting to investigate whether this protection also occurs when high blood pressure is lowered without medication. (ad)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Swell:

  • German Society for Neurology (DGN): Medicinal blood pressure therapy lowers the risk of dementia in people with high blood pressure, (accessed: 01.02.2020), German Society for Neurology (DGN)
  • Ding J, Davies-Plourde KL, Sedaghat S et al .: Antihypertensive medications and risk for incident dementia and Alzheimer's disease: a meta-analysis of individual participant data from prospective cohort studies; in: Lancet Neurology, (published: 06.11.2019 and in the January 2020 edition; 19: 61-70), Lancet Neurology
  • German Society for Neurology (DGN): Guideline: Diagnosis and Therapy of Dementias, (accessed: 01.02.2020), German Society for Neurology (DGN)
  • Jessica G Abell, Mika Kivimäki, Aline Dugravot, Adam G Tobak, Aurore Fayosse, Martin Shipley, Séverine Sabia, Archana Singh-Manoux: Association between systolic blood pressure and dementia in the Whitehall II cohort study: role of age, duration, and threshold used to define hypertension; in: European Heart Journal, (published: online June 12, 2018 and Volume 39, Issue 33, September 01, 2018, Pages 3119–3125), European Heart Journal


Video: Hypertension and Dementia (July 2022).


Comments:

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  2. Serapis

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  3. Reuben

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  4. Migor

    and this has the analog?

  5. Holter

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