 Advertisement | ||||||||
 | ||||||||
|
||||||||
 |
 |
 |
 |
 |
 |
 |
||
|
From (Maxwell, Hogan) the Department of Community Health Sciences, (Maxwell, Hogan) the Department of Medicine and (Hogan, Ebly) the Department of Clinical Neurosciences, University of Calgary, Calgary, Alta.
Abstract
Background: Concern has been raised about the potential for adverse cognitive effects associated with the use of calcium-channel blockers (CCBs) in older people. This study was undertaken to examine prospectively the association between the use of these and other antihypertensive drugs and cognitive function.
Methods: The authors examined data from the Canadian Study of Health and Aging (CSHA), a population-based, prospective 5-year investigation of the epidemiology of dementia and other health problems in Canadians 65 years of age and older. The risk of cognitive decline, as indicated by a decline in performance on the Modified Mini-Mental State (3MS) examination over the 5-year period, was assessed in relation to the use of antihypertensive and diuretic drugs by 205 subjects with a history of hypertension and no evidence of dementia at baseline.
Results: The proportion of subjects whose cognitive performance declined over the study period was significantly higher in the group using CCBs than in the group using other antihypertensive agents (75% v. 59%). The adjusted odds ratio (OR) for a significant decline in cognitive performance (defined as a decrease in 3MS score of 10 points or more) was 2.28 (95% confidence interval [CI] 1.12-4.66) for subjects using CCBs. The adjusted ORs (and 95% CIs) for cognitive decline in subjects using selected antihypertensive agents or diuretics relative to those exposed to beta-blockers were as follows: angiotensin-converting-enzyme inhibitor, OR 1.36 (95% CI 0.41-4.55); diuretic or other antihypertensive drug, OR 1.45 (95% CI 0.51-4.14); dihydropyridine CCB (nifedipine), OR 1.94 (95% CI 0.52-7.27) and non-dihydropyridine CCB (diltiazem or verapamil), OR 3.72 (95% CI 1.22-11.36).
Interpretation: Older people taking CCBs were significantly more likely than those using other agents to experience cognitive decline. These findings are consistent with the results of previous cross-sectional research and emphasize the need for further trials to examine the associations between CCB use, blood pressure and cognitive impairment in elderly patients.
This article has been cited by other articles:
|
|
 |
|
  C. H Rojas-Fernandez and P. Moorhouse Current Concepts in Vascular Cognitive Impairment and Pharmacotherapeutic Implications Ann. Pharmacother., July 1, 2009; 43(7): 1310 - 1323. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Scharf and K. R. Daffner NSAIDs in the prevention of dementia: A Cache-22? Neurology, July 17, 2007; 69(3): 235 - 236. [Full Text] [PDF]
|
|
|
|
|
|
S. Freels, D. L. Nyenhuis, and P. B. Gorelick Predictors of survival in African American patients with AD, VaD, or stroke without dementia Neurology, October 22, 2002; 59(8): 1146 - 1153. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Forette, M.-L. Seux, J. A. Staessen, L. Thijs, M.-R. Babarskiene, S. Babeanu, A. Bossini, R. Fagard, B. Gil-Extremera, T. Laks, et al. The Prevention of Dementia With Antihypertensive Treatment: New Evidence From the Systolic Hypertension in Europe (Syst-Eur) Study Arch Intern Med, October 14, 2002; 162(18): 2046 - 2052. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Hanon and D. Leys Cognitive decline and dementia in the elderly hypertensive Journal of Renin-Angiotensin-Aldosterone System, March 1, 2002; 3(1_suppl): S32 - S38. [PDF]
|
|
|
|
|
|
W. H. Birkenhager, F. Forette, M.-L. Seux, J.-G. Wang, and J. A. Staessen Blood Pressure, Cognitive Functions, and Prevention of Dementias in Older Patients With Hypertension Arch Intern Med, January 22, 2001; 161(2): 152 - 156. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. A. Heckman, A. Papaioannou, W. Parkinson, and C. A. Patterson {beta}-Blockers as first-line therapy for hypertension Can. Med. Assoc. J., November 1, 2000; 163(11): 1424 - 1425. [Full Text] [PDF]
|
|
|
|
 |
|
 J. S. Trilling and J. Froom The Urgent Need to Improve Hypertension Care Arch Fam Med, September 1, 2000; 9(9): 794 - 801. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Correction Can. Med. Assoc. J., November 1, 1999; 161(11): 1396 - 1396. [Full Text]
|
|
|
|
|
|
C. J.S. Patterson and D. B. Hogan Does treating hypertension protect against dementia? Can. Med. Assoc. J., October 1, 1999; 161(8): 943 - 943. [Full Text]
|
|
|
|
|
|
H. B. Dinsdale Searching for a link between calcium-channel blockers and cognitive function Can. Med. Assoc. J., September 1, 1999; 161(5): 534 - 535. [Full Text] [PDF]
|
|
Read all eLetters
| HOME | CURRENT ISSUE | PAST ISSUES | COLLECTIONS | HELP | SEARCH |
|
|||||
|
Copyright 1995-1999, Canadian Medical Association. All rights reserved. ISSN 1488-2329
(e) 0820-3946 (p)
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association. |
|||||
