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Risk of incident dementia in drug-untreated arterial hypertension: a population-based study

Authors

Bermejo-Pareja, Félix, Benito-León, Julián, Louis, Elan D., Trincado, Rocío, Carro, Eva, Villarejo, Alberto, de la Cámara, Agustín Gómez

Journal

Journal Of Alzheimer's Disease: JAD, Volume: 22, No.: 3, Pages.: 949-958

Year of Publication

2010

Abstract

Arterial hypertension in midlife may increase the risk of late-life dementia. Notably, there is conflicting data as to whether hypertension in the elderly (age 65 years and older) is a risk factor for dementia and Alzheimer’s disease (AD). We determined whether drug-untreated hypertension was associated with a higher risk of incident dementia and AD. In a population-based study of older people in central Spain (NEDICES), non-demented participants were followed prospectively. Dementia at follow-up was diagnosed using DSM-IV criteria. Using Cox proportional hazards models, the risk of dementia was estimated in participants with drug-untreated hypertension and in participants with drug-treated hypertension versus controls. The 3,824 participants had a mean duration of follow-up of 3.2 years. Sixty-two (3.3%) of 1,870 participants without baseline hypertension developed incident dementia versus 78 (4.7%) of 1,657 with drug-treated, baseline hypertension and 19 (12.0%) with drug-untreated, baseline hypertension. In an unadjusted Cox model, risk of dementia was increased in participants with drug-untreated hypertension (relative risk [RR] =1.93, 95% confidence interval [CI]=1.15–3.23, p = 0.01) and in participants with drug-treated hypertension (RR =1.43, 95% CI= 1.02–2.0, p =0.035) versus participants without hypertension (reference group). In a fully adjusted Cox model, the risk of dementia remained increased in participants with drug-untreated hypertension (RR =2.38, 95% CI =1.32–4.29, p=0.004). Results were similar for risk of AD. Our results suggest that drug-untreated hypertension may be an independent risk factor for dementia and AD in the elderly.;

Keywords

aged, aged, 80 and over, complications, dementia, epidemiology, etiology, female, humans, hypertension, incidence, male, population surveillance, prospective studies, questionnaires, risk factors

Countries of Study

Spain

Types of Dementia

Alzheimer’s Disease, Dementia (general / unspecified)

Types of Study

Cohort Study

Type of Interventions

Risk Factor Modification

Risk Factor Modifications

At risk population