There’s a Lower Risk of Alzheimer’s Disease in ARB Users

Almost 2 years ago I posted a report of a study from the US Veterans Affairs that showed an association between the use one type of anti-hypertensive drug, the angiotensin receptor blockers (ARBs) and a lessened rate of Alzheimer’s disease in men.  Now confirmation of this relationship comes from Bristol, UK, in a study reported in the Journal of Alzheimer’s Disease. 

The researchers set out to see whether ARBs and angiotensin converting enzyme inhibitors (ACE inhibitors) are more strongly associated with Alzheimer’s disease, vascular dementia, and other dementias, than other anti-hypertensive drugs.  They used a large family practitioner database to sample patients starting treatment with antihypertensive medications who were aged 60 or more and diagnosed between 1997 and 2008; there were 5,797 with Alzheimer’s, 2,186 with vascular dementia, and 1,214 with another or unspecified dementia. Up to 4 controls were selected, who were matched by age, gender, and family practice.  Odds-ratios and dose response effects were calculated for the 3 dementia groups in those prescribed ARBs or ACE inhibitors for at least 6 months with patients prescribed other antihypertensives.

The patients prescribed either ARBs or ACE inhibitors were less likely to develop any type of dementia than patients prescribed other antihypertensives.  The table gives the odds ratios, or likelihoods:

Outcome	Odds Ratio for ARBs	Odds Ratio for ACE inhibitors
Alzheimer’s	0.47	0.70
Vascular dementia	0.70	0.82
Other dementia	0.62	0.85

Age, other illnesses, or blood pressure levels did not influence these results.  On the other hand, there was evidence of a dose-relationship response between ARBs and Alzheimer’s, i.e. the higher the dose of ARB, the lower the likelihood of developing Alzheimer’s disease.

Showing due caution, the investigators point out that these findings require further confirmation in randomized, well-controlled prospective studies – something that will be hard to do and may take years.  In the meantime, many of us with hypertension will be happy to know we are taking an ARB, offering the best – yet - protection against Alzheimer’s (except for eating right and exercising a lot).