Duration of antihypertensive drug use and risk of dementia A prospective cohort study
Duration of antihypertensive drug use and risk of dementia A prospective cohort study
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DOI：
10.1212/01.wnl.0000345062.86148.3f
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发表时间：
2009-05-19
期刊：
影响因子：
9.9
通讯作者：
Stricker, B. H. C.
中科院分区：
文献类型：
--
作者：
Haag, M. D. M.;Hofman, A.;Stricker, B. H. C.
背景资料：前瞻性观察性研究的证据表明，抗高血压药物的使用对痴呆症的风险具有保护作用，但这一证据远未统一。随访持续时间有限，主要依赖于基线药物暴露数据，没有使用持续时间的信息。我们调查了抗高血压药物使用的持续时间和痴呆症的风险之间的关联。方法：我们随访了6,249名参与者（平均68.4年，60%的女性）的前瞻性，以人群为基础的队列从基线（1990-1993年），直到2005年的事件痴呆症。关于已填写处方的连续数据来自药房记录。抗高血压药物使用的总累积持续时间以年表示。我们在量化暴露持续时间时减去痴呆诊断日期前的4年潜伏期，以避免由于血压或认知的前驱变化而导致的抗高血压处方的潜在偏倚。与考克斯回归模型，我们计算了粗和调整后的风险比（HR）的所有痴呆症和阿尔茨海默病（AD）与抗高血压药物的使用与从未used.Results：相比，从未使用，抗高血压药物的使用与所有痴呆症的风险降低（调整后的HR每年使用0.95; 95%置信区间[CI] 0.91-0.99）。我们观察到，对于75岁的人，每年使用8%（95% CI -15%至1%）的风险降低，这是4%（95% CI -11%至4%）。观察到AD的等效估计值。不同类型的抗高血压药物之间无明显差异。结论：抗高血压药物的使用与每年使用人群痴呆风险降低8%相关
Background: The evidence from prospective observational research for a protective effect of antihypertensive drug use on the risk of dementia is far from uniform. Duration of follow-up was limited and relied mainly on baseline drug exposure data without information on duration of use. We investigated the association between the duration of antihypertensive use and risk of dementia.Methods: We followed 6,249 participants (mean 68.4 years, 60% women) of a prospective, population-based cohort from baseline (1990-1993) until 2005 for incident dementia. Continuous data on filled prescriptions came from pharmacy records. Total cumulative duration of antihypertensive use was expressed in years. We subtracted a latent 4-year period before the date of dementia diagnosis in the quantification of exposure duration to avoid potential bias in antihypertensive prescription due to prodromal changes in blood pressure or cognition. With Cox regression models, we calculated crude and adjusted hazard ratios (HRs) of all dementia and Alzheimer disease (AD) with antihypertensive use vs never used.Results: Compared to never used, antihypertensive use was associated with a reduced risk of all dementia (adjusted HR per year of use 0.95; 95% confidence interval [CI] 0.91-0.99). We observed an 8% (95% CI -15% to -1%) risk reduction per year of use for persons 75 years this was 4% (95% CI -11% to 4%). Equivalent estimates were observed for AD. No apparent differences were observed among different types of antihypertensive drugs.Conclusions: Antihypertensive drug use was associated with 8% risk reduction of dementia per year of use for persons