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01.02.2015 | Systematic Review

Antihypertensive Drugs, Prevention of Cognitive Decline and Dementia: A Systematic Review of Observational Studies, Randomized Controlled Trials and Meta-Analyses, with Discussion of Potential Mechanisms

verfasst von: Laure Rouch, Philippe Cestac, Olivier Hanon, Charlène Cool, Catherine Helmer, Béatrice Bouhanick, Bernard Chamontin, Jean-Franҫois Dartigues, Bruno Vellas, Sandrine Andrieu

Erschienen in: CNS Drugs | Ausgabe 2/2015

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Abstract

Background

Chronic hypertension, particularly midlife high blood pressure, has been associated with an increased risk for cognitive decline and dementia. In this context, antihypertensive drugs might have a preventive effect, but the association remains poorly understood.

Objectives

The aim of this systematic review was to examine all published findings that investigated this relationship and discuss the mechanisms underlying the potential benefits of antihypertensive medication use.

Methods

A literature search was conducted using MEDLINE, Embase, and the Cochrane Library for publications from 1990 onwards mentioning hypertension, antihypertensive drugs, cognitive decline, and dementia.

Results

A total of 38 relevant publications, corresponding to 18 longitudinal studies, 11 randomized controlled trials, and nine meta-analyses were identified from the 10,251 articles retrieved in the literature search. In total, 1,346,176 subjects were included in these studies; the average age was 74 years. In the seven longitudinal studies assessing the effect of antihypertensive medication on cognitive impairment or cognitive decline, antihypertensive drugs appeared to be beneficial. Of the 11 longitudinal studies that assessed the effect of antihypertensive medication on incidence of dementia, only three did not find a significant protective effect. Antihypertensive medication could decrease the risk of not only vascular dementia but also Alzheimer’s disease. Four randomized controlled trials showed a potentially preventive effect of antihypertensive drugs on the incidence of dementia or cognitive decline: SYST-EUR (Systolic Hypertension in Europe Study) I and II, with a 55 % reduction in dementia risk (3.3 vs. 7.4 cases per 1,000 patient years; p < 0.001); HOPE (Heart Outcomes Prevention Evaluation), with a 41 % reduction in cognitive decline associated with stroke (95 % confidence interval [CI] 6–63); and PROGRESS (Perindopril Protection against Recurrent Stroke Study), with a 19 % reduction in cognitive decline (95 % CI 4–32; p = 0.01). Meta-analyses have sometimes produced conflicting results, but this may be due to methodological considerations. The lack of homogeneity across study designs, patient populations, exposition, outcomes, and duration of follow-up are the most important methodological limitations that might explain the discrepancies between some of these studies.

Conclusion

Antihypertensive drugs, particularly calcium channel blockers and renin–angiotensin system blockers, may be beneficial in preventing cognitive decline and dementia. However, further randomized controlled trials with longer periods of follow-up and cognition as the primary outcome are needed to confirm these findings.

Ferri CP, Prince M, Brayne C, Brodaty H, Fratiglioni L, Ganguli M, et al. Global prevalence of dementia: a Delphi consensus study. Lancet. 2005;366(9503):2112–7.CrossRefPubMedCentralPubMed

Viswanathan A, Rocca WA, Tzourio C. Vascular risk factors and dementia: how to move forward? Neurology. 2009;72(4):368–74.CrossRefPubMedCentralPubMed

Qiu C, Winblad B, Fratiglioni L. The age-dependent relation of blood pressure to cognitive function and dementia. Lancet Neurol. 2005;4(8):487–99.CrossRefPubMed

Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339–b2535.

Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17(1):1–12.CrossRefPubMed

Shah K, Qureshi SU, Johnson M, Parikh N, Schulz PE, Kunik ME. Does use of antihypertensive drugs affect the incidence or progression of dementia? A systematic review. Am J Geriatr Pharmacother. 2009;7(5):250–61.CrossRefPubMed

Sink KM, Leng X, Williamson J, Kritchevsky SB, Yaffe K, Kuller L, et al. Angiotensin-converting enzyme inhibitors and cognitive decline in older adults with hypertension: results from the Cardiovascular Health Study. Arch Intern Med. 2009;169(13):1195–202.CrossRefPubMedCentralPubMed

Hanon O, Berrou J-P, Negre-Pages L, Goch JH, Nádházi Z, Petrella R, et al. Effects of hypertension therapy based on eprosartan on systolic arterial blood pressure and cognitive function: primary results of the Observational Study on Cognitive function And Systolic Blood Pressure Reduction open-label study. J Hypertens. 2008;26(8):1642–50.CrossRefPubMed

Li N-C, Lee A, Whitmer RA, Kivipelto M, Lawler E, Kazis LE, et al. Use of angiotensin receptor blockers and risk of dementia in a predominantly male population: prospective cohort analysis. BMJ. 2010;340:b5465.CrossRefPubMedCentralPubMed

10.

Johnson ML, Parikh N, Kunik ME, Schulz PE, Patel JG, Chen H, et al. Antihypertensive drug use and the risk of dementia in patients with diabetes mellitus. Alzheimers Dement J Alzheimers Assoc. 2012;8(5):437–44.CrossRef

11.

Soto ME, van Kan GA, Nourhashemi F, Gillette-Guyonnet S, Cesari M, Cantet C, et al. Angiotensin-converting enzyme inhibitors and Alzheimer’s disease progression in older adults: results from the Réseau sur la Maladie d’Alzheimer Français Cohort. J Am Geriatr Soc. 2013;61(9):1482–8.CrossRefPubMed

12.

Bosch J, Yusuf S, Pogue J, Sleight P, Lonn E, Rangoonwala B, et al. Use of ramipril in preventing stroke: double blind randomised trial. BMJ. 2002;324(7339):699–702.CrossRefPubMedCentralPubMed

13.

Diener H-C, Sacco RL, Yusuf S, Cotton D, Ounpuu S, Lawton WA, et al. Effects of aspirin plus extended-release dipyridamole versus clopidogrel and telmisartan on disability and cognitive function after recurrent stroke in patients with ischaemic stroke in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial: a double-blind, active and placebo-controlled study. Lancet Neurol. 2008;7(10):875–84.CrossRefPubMedCentralPubMed

14.

Tzourio C, Anderson C, Chapman N, Woodward M, Neal B, MacMahon S, et al. Effects of blood pressure lowering with perindopril and indapamide therapy on dementia and cognitive decline in patients with cerebrovascular disease. Arch Intern Med. 2003;163(9):1069–75.CrossRefPubMed

15.

Anderson C, Teo K, Gao P, Arima H, Dans A, Unger T, et al. Renin-angiotensin system blockade and cognitive function in patients at high risk of cardiovascular disease: analysis of data from the ONTARGET and TRANSCEND studies. Lancet Neurol. 2011;10(1):43–53.CrossRefPubMed

16.

Tzourio C, Dufouil C, Ducimetière P, Alpérovitch A. Cognitive decline in individuals with high blood pressure: a longitudinal study in the elderly. EVA Study Group. Epidemiology of vascular aging. Neurology. 1999;53(9):1948–52.CrossRefPubMed

17.

Murray MD, Lane KA, Gao S, Evans RM, Unverzagt FW, Hall KS, et al. Preservation of cognitive function with antihypertensive medications: a longitudinal analysis of a community-based sample of African Americans. Arch Intern Med. 2002;162(18):2090–6.CrossRefPubMed

18.

Hajjar I, Catoe H, Sixta S, Boland R, Johnson D, Hirth V, et al. Cross-sectional and longitudinal association between antihypertensive medications and cognitive impairment in an elderly population. J Gerontol A Biol Sci Med Sci. 2005;60(1):67–73.CrossRefPubMed

19.

Gelber RP, Ross GW, Petrovitch H, Masaki KH, Launer LJ, White LR. Antihypertensive medication use and risk of cognitive impairment: the Honolulu-Asia Aging Study. Neurology. 2013;81(10):888–95.CrossRefPubMedCentralPubMed

20.

Qiu C, von Strauss E, Fastbom J, Winblad B, Fratiglioni L. Low blood pressure and risk of dementia in the Kungsholmen project: a 6-year follow-up study. Arch Neurol. 2003;60(2):223–8.CrossRefPubMed

21.

Khachaturian AS, Zandi PP, Lyketsos CG, Hayden KM, Skoog I, Norton MC, et al. Antihypertensive medication use and incident Alzheimer disease: the Cache County Study. Arch Neurol. 2006;63(5):686–92.CrossRefPubMed

22.

Peila R, White LR, Masaki K, Petrovitch H, Launer LJ. Reducing the risk of dementia: efficacy of long-term treatment of hypertension. Stroke J Cereb Circ. 2006;37(5):1165–70.CrossRef

23.

Yasar S, Xia J, Yao W, Furberg CD, Xue Q-L, Mercado CI, et al. Antihypertensive drugs decrease risk of Alzheimer disease: Ginkgo Evaluation of Memory Study. Neurology. 2013;81(10):896–903.CrossRefPubMedCentralPubMed

24.

Haag MDM, Hofman A, Koudstaal PJ, Breteler MMB, Stricker BHC. Duration of antihypertensive drug use and risk of dementia: a prospective cohort study. Neurology. 2009;72(20):1727–34.CrossRefPubMed

25.

In’t Veld BA, Ruitenberg A, Hofman A, Stricker BH, Breteler MM. Antihypertensive drugs and incidence of dementia: the Rotterdam Study. Neurobiol Aging. 2001;22(3):407–12.CrossRefPubMed

26.

Morris MC, Scherr PA, Hebert LE, Glynn RJ, Bennett DA, Evans DA. Association of incident Alzheimer disease and blood pressure measured from 13 years before to 2 years after diagnosis in a large community study. Arch Neurol. 2001;58(10):1640–6.CrossRefPubMed

27.

Lindsay J, Laurin D, Verreault R, Hébert R, Helliwell B, Hill GB, et al. Risk factors for Alzheimer’s disease: a prospective analysis from the Canadian Study of Health and Aging. Am J Epidemiol. 2002;156(5):445–53.CrossRefPubMed

28.

Yasar S, Corrada M, Brookmeyer R, Kawas C. Calcium channel blockers and risk of AD: the Baltimore Longitudinal Study of Aging. Neurobiol Aging. 2005;26(2):157–63.CrossRefPubMed

29.

Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med. 2000;342(3):145–53.CrossRefPubMed

30.

No authors listed. Medical Research Council trial of treatment of hypertension in older adults: principal results. MRC Working Party. BMJ. 1992;304(6824):405–12.CrossRef

31.

Prince MJ, Bird AS, Blizard RA, Mann AH. Is the cognitive function of older patients affected by antihypertensive treatment? Results from 54 months of the Medical Research Council’s trial of hypertension in older adults. BMJ. 1996;312(7034):801–5.CrossRefPubMedCentralPubMed

32.

Lithell H, Hansson L, Skoog I, Elmfeldt D, Hofman A, Olofsson B, et al. The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial. J Hypertens. 2003;21(5):875–86.CrossRefPubMed

33.

Beckett NS, Peters R, Fletcher AE, Staessen JA, Liu L, Dumitrascu D, et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med. 2008;358(18):1887–98.CrossRefPubMed

34.

Peters R, Beckett N, Forette F, Tuomilehto J, Clarke R, Ritchie C, et al. Incident dementia and blood pressure lowering in the Hypertension in the Very Elderly Trial cognitive function assessment (HYVET-COG): a double-blind, placebo controlled trial. Lancet Neurol. 2008;7(8):683–9.CrossRefPubMed

35.

Staessen JA, Fagard R, Thijs L, Celis H, Arabidze GG, Birkenhäger WH, et al. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. The Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Lancet. 1997;350(9080):757–64.CrossRefPubMed

36.

Forette F, Seux ML, Staessen JA, Thijs L, Birkenhäger WH, Babarskiene MR, et al. Prevention of dementia in randomised double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial. Lancet. 1998;352(9137):1347–51.CrossRefPubMed

37.

Forette F, Seux M-L, Staessen JA, Thijs L, Babarskiene M-R, Babeanu S, et al. The prevention of dementia with antihypertensive treatment: new evidence from the Systolic Hypertension in Europe (Syst-Eur) study. Arch Intern Med. 2002;162(18):2046–52.CrossRefPubMed

38.

Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group. JAMA. 1991;265(24):3255–64.

39.

Applegate WB, Pressel S, Wittes J, Luhr J, Shekelle RB, Camel GH, et al. Impact of the treatment of isolated systolic hypertension on behavioral variables. Results from the systolic hypertension in the elderly program. Arch Intern Med. 1994;154(19):2154–60.CrossRefPubMed

40.

Di Bari M, Pahor M, Franse LV, Shorr RI, Wan JY, Ferrucci L, et al. Dementia and disability outcomes in large hypertension trials: lessons learned from the systolic hypertension in the elderly program (SHEP) trial. Am J Epidemiol. 2001;153(1):72–8.CrossRefPubMed

41.

Chang-Quan H, Hui W, Chao-Min W, Zheng-Rong W, Jun-Wen G, Yong-Hong L, et al. The association of antihypertensive medication use with risk of cognitive decline and dementia: a meta-analysis of longitudinal studies. Int J Clin Pract. 2011;65(12):1295–305.CrossRefPubMed

42.

Guan J-W, Huang C-Q, Li Y-H, Wan C-M, You C, Wang Z-R, et al. No association between hypertension and risk for Alzheimer’s disease: a meta-analysis of longitudinal studies. J Alzheimers Dis JAD. 2011;27(4):799–807.

43.

Feigin V, Ratnasabapathy Y, Anderson C. Does blood pressure lowering treatment prevents dementia or cognitive decline in patients with cardiovascular and cerebrovascular disease? J Neurol Sci. 2005;229–230:151–5.CrossRefPubMed

44.

Birns J, Morris R, Donaldson N, Kalra L. The effects of blood pressure reduction on cognitive function: a review of effects based on pooled data from clinical trials. J Hypertens. 2006;24(10):1907–14.CrossRefPubMed

45.

Birkenhäger WH, Staessen JA. Progress in cardiovascular diseases: cognitive function in essential hypertension. Prog Cardiovasc Dis. 2006;49(1):1–10.CrossRefPubMed

46.

McGuinness B, Todd S, Passmore P, Bullock R. Blood pressure lowering in patients without prior cerebrovascular disease for prevention of cognitive impairment and dementia. Cochrane Database Syst Rev Online. 2009;4:CD004034.

47.

López-Arrieta JM, Birks J. Nimodipine for primary degenerative, mixed and vascular dementia. Cochrane Database Syst Rev. 2002;3:CD000147.PubMed

48.

Levi Marpillat N, Macquin-Mavier I, Tropeano A-I, Bachoud-Levi A-C, Maison P. Antihypertensive classes, cognitive decline and incidence of dementia: a network meta-analysis. J Hypertens. 2013;31(6):1073–82.CrossRefPubMed

49.

Pohjasvaara T, Erkinjuntti T, Vataja R, Kaste M. Dementia three months after stroke. Baseline frequency and effect of different definitions of dementia in the Helsinki Stroke Aging Memory Study (SAM) cohort. Stroke. 1997;28(4):785–92.CrossRefPubMed

50.

Kokmen E, Whisnant JP, O’Fallon WM, Chu CP, Beard CM. Dementia after ischemic stroke: a population-based study in Rochester, Minnesota (1960–1984). Neurology. 1996;46(1):154–9.CrossRefPubMed

51.

Collins R, Peto R, MacMahon S, Hebert P, Fiebach NH, Eberlein KA, Godwin J, Qizilbash N, Taylor JO, Hennekens CH. Blood pressure, stroke, and coronary heart disease. Part 2. Short-term reductions in blood pressure: overview of randomised drug trials in their epidemiological context. Lancet. 1990;335(8693):827–38 (Review).CrossRefPubMed

52.

Birkenhäger WH, Forette F, Seux ML, Wang JG, Staessen JA. Blood pressure, cognitive performance, and prevention of dementias in older patients with hypertension. Arch Intern Med. 2001;161:152–6.CrossRefPubMed

53.

Launer LJ, Ross GW, Petrovitch H, Masaki K, Foley D, White LR, Havlik RJ. Midlife blood pressure and dementia: the Honolulu-Asia aging study. Neurobiol Aging. 2000;21(1):49–55.CrossRefPubMed

54.

Lopez OL, Kuller LH, Becker JT, et al. Classification of vascular dementia in the Cardiovascular Health Study Cognition Study. Neurology. 2005;64:1539–47.CrossRefPubMed

55.

Hainsworth AH, Markus HS. Do in vivo experimental models reflect human cerebral small vessel disease? A systematic review. J Cereb Blood Flow Metab Off J Int Soc Cereb Blood Flow Metab. 2008;28(12):1877–91.CrossRef

56.

Liao D, Cooper L, Cai J, Toole JF, Bryan NR, Hutchinson RG, et al. Presence and severity of cerebral white matter lesions and hypertension, its treatment, and its control. The ARIC Study. Atherosclerosis Risk in Communities Study. Stroke J Cereb Circ. 1996;27(12):2262–70.CrossRef

57.

Suter O-C, Sunthorn T, Kraftsik R, Straubel J, Darekar P, Khalili K, et al. Cerebral hypoperfusion generates cortical watershed microinfarcts in Alzheimer disease. Stroke J Cereb Circ. 2002;33(8):1986–92.CrossRef

58.

Pasquier F, Leys D. Why are stroke patients prone to develop dementia? J Neurol. 1997;244(3):135–42.CrossRefPubMed

59.

Hardy JA, Mann DM, Wester P, Winblad B. An integrative hypothesis concerning the pathogenesis and progression of Alzheimer’s disease. Neurobiol Aging. 1986;7(6):489–502.CrossRefPubMed

60.

Zhang X, Zhou K, Wang R, Cui J, Lipton SA, Liao F-F, et al. Hypoxia-inducible factor 1alpha (HIF-1alpha)-mediated hypoxia increases BACE1 expression and beta-amyloid generation. J Biol Chem. 2007;282(15):10873–80.CrossRefPubMed

61.

Iadecola C, Park L, Capone C. Threats to the mind: aging, amyloid, and hypertension. Stroke J Cereb Circ. 2009;40(3 Suppl):S40–4.CrossRef

62.

Angeli F, Verdecchia P, Reboldi GP, Gattobigio R, Bentivoglio M, Staessen JA, Porcellati C. Calcium channel blockade to prevent stroke in hypertension: a meta-analysis of 13 studies with 103.793 subjects. Am J Hypertens. 2004;17:817–22.PubMed

63.

Berridge MJ. Calcium signalling and Alzheimer’s disease. Neurochem Res. 2011;36(7):1149–56.CrossRefPubMed

64.

Thibault O, Gant JC, Landfield PW. Expansion of the calcium hypothesis of brain aging and Alzheimer’s disease: minding the store. Aging Cell. 2007;6(3):307–17.CrossRefPubMedCentralPubMed

65.

Thibault O, Landfield PW. Increase in single L-type calcium channels in hippocampal neurons during aging. Science. 1996;272(5264):1017–20.CrossRefPubMed

66.

Pierrot N, Ghisdal P, Caumont A-S, Octave J-N. Intraneuronal amyloid-beta1-42 production triggered by sustained increase of cytosolic calcium concentration induces neuronal death. J Neurochem. 2004;88(5):1140–50.CrossRefPubMed

67.

Querfurth HW, Selkoe DJ. Calcium ionophore increases amyloid beta peptide production by cultured cells. Biochemistry (Mosc). 1994;33(15):4550–61.CrossRef

68.

Mattson MP. Antigenic changes similar to those seen in neurofibrillary tangles are elicited by glutamate and Ca²⁺ influx in cultured hippocampal neurons. Neuron. 1990;4(1):105–17.CrossRefPubMed

69.

Nixon RA. The calpains in aging and aging-related diseases. Ageing Res Rev. 2003;2(4):407–18.CrossRefPubMed

70.

Green KN, LaFerla FM. Linking calcium to Abeta and Alzheimer’s disease. Neuron. 2008;59(2):190–4.CrossRefPubMed

71.

Kuchibhotla KV, Goldman ST, Lattarulo CR, Wu H-Y, Hyman BT, Bacskai BJ. Abeta plaques lead to aberrant regulation of calcium homeostasis in vivo resulting in structural and functional disruption of neuronal networks. Neuron. 2008;59(2):214–25.CrossRefPubMedCentralPubMed

72.

Yu J-T, Chang RC-C, Tan L. Calcium dysregulation in Alzheimer’s disease: from mechanisms to therapeutic opportunities. Prog Neurobiol. 2009;89(3):240–55.CrossRefPubMed

73.

Mattson MP. Cellular actions of beta-amyloid precursor protein and its soluble and fibrillogenic derivatives. Physiol Rev. 1997;77(4):1081–132.PubMed

74.

Furukawa K, Wang Y, Yao PJ, Fu W, Mattson MP, Itoyama Y, et al. Alteration in calcium channel properties is responsible for the neurotoxic action of a familial frontotemporal dementia tau mutation. J Neurochem. 2003;87(2):427–36.CrossRefPubMed

75.

Trompet S, Westendorp RGJ, Kamper AM, de Craen AJM. Use of calcium antagonists and cognitive decline in old age. The Leiden 85-plus study. Neurobiol Aging. 2008;29(2):306–8.CrossRefPubMed

76.

Barnes JM, Barnes NM, Costall B, Horovitz ZP, Ironside JW, Naylor RJ, et al. Angiotensin II inhibits acetylcholine release from human temporal cortex: implications for cognition. Brain Res. 1990;507(2):341–3.CrossRefPubMed

77.

Hemming ML, Selkoe DJ. Amyloid beta-protein is degraded by cellular angiotensin-converting enzyme (ACE) and elevated by an ACE inhibitor. J Biol Chem. 2005;280(45):37644–50.CrossRefPubMedCentralPubMed

78.

Tuppo EE, Arias HR. The role of inflammation in Alzheimer’s disease. Int J Biochem Cell Biol. 2005;37(2):289–305.CrossRefPubMed

79.

Carson JA, Turner AJ. Beta-amyloid catabolism: roles for neprilysin (NEP) and other metallopeptidases? J Neurochem. 2002;81(1):1–8.CrossRefPubMed

80.

Wang J, Ho L, Chen L, Zhao Z, Zhao W, Qian X, et al. Valsartan lowers brain beta-amyloid protein levels and improves spatial learning in a mouse model of Alzheimer disease. J Clin Invest. 2007;117(11):3393–402.CrossRefPubMedCentralPubMed

81.

Mogi M, Li J-M, Tsukuda K, Iwanami J, Min L-J, Sakata A, et al. Telmisartan prevented cognitive decline partly due to PPAR-gamma activation. Biochem Biophys Res Commun. 2008;375(3):446–9.CrossRefPubMed

82.

McCabe RD, Bakarich MA, Srivastava K, Young DB. Potassium inhibits free radical formation. Hypertension. 1994;24(1):77–82.CrossRefPubMed

83.

Ishimitsu T, Tobian L, Sugimoto K, Everson T. High potassium diets reduce vascular and plasma lipid peroxides in stroke-prone spontaneously hypertensive rats. Clin Exp Hypertens NYN 1993. 1996;18(5):659–73.

84.

Young DB, Ma G. Vascular protective effects of potassium. Semin Nephrol. 1999;19(5):477–86.PubMed

85.

Chen WT, Brace RA, Scott JB, Anderson DK, Haddy FJ. The mechanism of the vasodilator action of potassium. Proc Soc Exp Biol Med Soc Exp Biol Med NYN. 1972;140(3):820–4.CrossRef

86.

Norton S, Matthews FE, Barnes DE, Yaffe K, Brayne C. Potential form primary prevention of Alzheimer’s disease: an analysis of population-based data. Lancet Neurol. 2014;13(8):788–94.CrossRefPubMed

87.

Seshadri S, Wolf PA. Lifetime risk of stroke and dementia: current concepts, and estimates from the Framingham Study. Lancet Neurol. 2007;6(12):1106–14.CrossRefPubMed

88.

Schaller S, Mauskopf J, Kriza C, Wahlster P, Kolominsky-Rabas PL. The main cost drivers in dementia: a systematic review. Int J Geriatr Psychiatry. 2014. doi:10.1002/gps.4198.

Titel: Antihypertensive Drugs, Prevention of Cognitive Decline and Dementia: A Systematic Review of Observational Studies, Randomized Controlled Trials and Meta-Analyses, with Discussion of Potential Mechanisms
verfasst von: Laure Rouch
Philippe Cestac
Olivier Hanon
Charlène Cool
Catherine Helmer
Béatrice Bouhanick
Bernard Chamontin
Jean-Franҫois Dartigues
Bruno Vellas
Sandrine Andrieu
Publikationsdatum: 01.02.2015
Verlag: Springer International Publishing
Erschienen in: CNS Drugs / Ausgabe 2/2015
Print ISSN: 1172-7047
Elektronische ISSN: 1179-1934
DOI: https://doi.org/10.1007/s40263-015-0230-6

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