• Journal of hypertension · Sep 2018

    Meta Analysis

    Blood pressure-lowering interventions to prevent dementia: a systematic review and meta-analysis.

    • Tessa van Middelaar, Lonneke A van Vught, Willem A van Gool, Esther M F Simons, van den BornBert-Jan HBHDepartment of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands., Eric P Moll van Charante, and Edo Richard.
    • Department of Neurology, Academic Medical Center, Amsterdam.
    • J. Hypertens. 2018 Sep 1; 36 (9): 1780-1787.

    Abstract: Our objective was to study the preventive effect of lowering blood pressure (BP) by medication and/or lifestyle changes on incident all-cause dementia, Alzheimer's disease and vascular dementia. In this systematic review, we included randomized controlled trials with a BP-lowering intervention. Of the nine included trials, seven assessed the effect of antihypertensive medication and two of a lifestyle or combined intervention. In the intervention arm, 1041 out of 29 029 (3.6%) participants were diagnosed with dementia compared with 1090 out of 28 653 (3.8%) controls during a median follow-up of 3.9 years [range 2-10], resulting in a pooled risk ratio of 0.93 (95% confidence interval 0.84-1.02; I 16%). Three trials specified dementia subtypes, with no significant effect on Alzheimer's disease or vascular dementia. To conclude, lowering BP by medication and/or lifestyle changes did not lead to a significantly reduced risk of dementia. This appeared independent of dementia subtype.

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