Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Hypertension and Circulatory Control
Angiotensin-Receptor Blockers and Risk of Alzheimer’s Disease in Hypertension Population
– A Nationwide Cohort Study –
Chien-Yi HsuChin-Chou HuangWan-Leong ChanPo-Hsun HuangChia-Hung ChiangTzeng-Ji ChenChia-Min ChungShing-Jong LinJaw-Wen ChenHsin-Bang Leu
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Supplementary material

2013 Volume 77 Issue 2 Pages 405-410


Background: Although emerging evidence shows angiotensin-receptor blockers (ARBs) may have a beneficial effect against Alzheimer’s disease (AD), the association is not consistent. We investigated the association between ARB use and the risk of development of AD using a nationwide, population-based cohort database in Taiwan. Methods and Results: In total, 16,426 newly diagnosed hypertensive patients who were administered ARB without a previous diagnosis of AD were identified from the Taiwan National Health Insurance database. The comparison group consisted of hypertensive patients who did not receive ARB, and were matched to exposed individuals using propensity score by enrolled time, age, sex, and comorbidities. During an average of 5.24±2.01 years of follow-up, a total of 1,031 cases (3.13%) of new AD occurred. The log-rank test showed no significant difference in the AD occurrence rate between subjects exposed to ARBs and non-exposed controls [488 (2.97%) vs. 543 (3.29%), P=0.221]. After adjusting for age, sex, comorbidities, and medications, only advanced age [hazard ratio (HR) 1.12, 95% confidence interval (CI) 1.12–1.13, P<0.001), female sex (HR 1.18, 95% CI 1.04–1.33, P=0.011), diabetes (HR 1.53, 95% CI 1.31–1.79, P<0.001), but not ARB (HR 1.08, 95% CI 0.96–1.22, P=0.222) were independently associated with AD development. Conclusions: The use of ARB was not significantly associated with a reduction of risk of AD in Asian patients with essential hypertension.  (Circ J 2013; 77: 405–410)

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