Please use this identifier to cite or link to this item: https://hdl.handle.net/1959.11/26965
Title: Diuretic antihypertensive drugs and incident dementia risk: a systematic review, meta-analysis and meta-regression of prospective studies
Contributor(s): Tully, Phillip J  (author)orcid ; Hanon, Olivier (author); Cosh, Suzanne  (author)orcid ; Tzourio, Christophe (author)
Publication Date: 2016-06
DOI: 10.1097/HJH.0000000000000868
Handle Link: https://hdl.handle.net/1959.11/26965
Abstract: 

Objective: Diuretic drugs have been a mainstay of hypertension treatment in the elderly however their dementia sparing effects are under-reported. The objective was to quantify dementia risk in relation to diuretic antihypertensive drugs.

Methods: Electronic databases were searched until June 2015. Eligibility criteria: population, adults without dementia from primary care, community cohort, residential/institutionalized, or randomized controlled trial; exposure, diuretic antihypertensive drug; comparison, no diuretic drug, other or no antihypertensive drug, placebo-control; outcome, incident dementia diagnosed by standardized criteria. Adjusted hazard ratios (HR) with 95% confidence intervals (CI) were pooled in fixed-effects models with RevMan 5.3 (The Nordic Cochrane Centre, Copenhagen, Denmark) and the findings rated according to The Grading of Recommendations Assessment, Development and Evaluation criteria.

Results: A total of 15 articles were included (52 599 persons, 3444 dementia cases, median age 76.1 years) and median follow-up was 6.1 years. Diuretics were associated with reduced dementia risk (HR 0.83; 95% CI 0.76-0.91, P < 0.0001, I2 = 0) and Alzheimer's disease risk (HR 0.82; 95% CI 0.71-0.94, P = 0.004, I2 = 0). Stratified analysis indicated a difference between potassium sparing, thiazide and loop diuretics (P = 0.01). Risk estimates were generally consistent comparing monotherapy vs. combination therapy, study design and follow-up. Meta-regression showed that demographics, stroke, heart failure, diabetes, liver disease, attrition, mortality rate, cognitive function, and apolipoprotein E allele did not moderate the results.

Conclusion: Diuretic antihypertensive drugs were associated with a consistent reduction in dementia risk without heterogeneity, pointing to generalizability of these findings.

Publication Type: Journal Article
Source of Publication: Journal of Hypertension, 34(6), p. 1027-1035
Publisher: Lippincott Williams & Wilkins
Place of Publication: United States of America
ISSN: 0263-6352
1473-5598
Fields of Research (FoR) 2008: 170102 Developmental Psychology and Ageing
110201 Cardiology (incl. Cardiovascular Diseases)
110319 Psychiatry (incl. Psychotherapy)
Fields of Research (FoR) 2020: 320221 Psychiatry (incl. psychotherapy)
320101 Cardiology (incl. cardiovascular diseases)
520106 Psychology of ageing
Socio-Economic Objective (SEO) 2008: 920103 Cardiovascular System and Diseases
970117 Expanding Knowledge in Psychology and Cognitive Sciences
970111 Expanding Knowledge in the Medical and Health Sciences
Socio-Economic Objective (SEO) 2020: 280103 Expanding knowledge in the biomedical and clinical science
280112 Expanding knowledge in the health sciences
280121 Expanding knowledge in psychology
Peer Reviewed: Yes
HERDC Category Description: C1 Refereed Article in a Scholarly Journal
Appears in Collections:Journal Article
School of Psychology

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