期刊
NEUROLOGY
卷 81, 期 10, 页码 888-895出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0b013e3182a351d4
关键词
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资金
- National Institute on Aging [N01-AG-4-2149, UO1 AG017155, UO1 AG019349]
- Intramural Research Program, NIA
- National Heart, Lung, and Blood Institute [N01-HC-05102]
- Office of Research and Development, Medical Research Service, Department of Veterans Affairs
Objective: To determine the associations between classes of antihypertensive medication use and the risk of cognitive impairment among elderly hypertensive men. Methods: The Honolulu-Asia Aging Study is a prospective, community-based cohort study of Japanese American men conducted in Honolulu, Hawaii. We examined 2,197 participants (mean age 77 years at cohort entry, 1991-1993, followed through September 2010) with hypertension and without dementia or cognitive impairment at baseline, who provided information on medication use. Cognitive function was assessed at 7 standardized examinations using the Cognitive Abilities Screening Instrument (CASI). Cognitive impairment was defined as a CASI score <74. Results: A total of 854 men developed cognitive impairment (median follow-up, 5.8 years). beta-Blocker use as the sole antihypertensive drug at baseline was consistently associated with a lower risk of cognitive impairment (incidence rate ratio [IRR] 0.69; 95% confidence interval [CI] 0.50-0.94), as compared with men not taking any antihypertensive medications, adjusting for multiple potential confounders. The use of diuretics, calcium channel blockers, angiotensin-converting enzyme inhibitors, or vasodilators alone was not significantly associated with cognitive impairment. Results were similar excluding those with cardiovascular disease or <1 year of follow-up, and additionally adjusting for pulse pressure, heart rate, baseline and midlife systolic blood pressure, and midlife antihypertensive treatment (IRR 0.65; 95% CI 0.45-0.94). The association between beta-blocker use and cognitive impairment was stronger among men with diabetes, men aged >75 years, and those with pulse pressure >= 70 mm Hg. Conclusions: beta-blocker use is associated with a lower risk of developing cognitive impairment in elderly Japanese American men.
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