Age Ageing

Which antihypertensive drug classes may lower risk of dementia?

June 17, 2025

Study details: This multinational population-based cohort study analyzed data from EHRs across Hong Kong, the UK, Sweden, and Australia. Using a harmonized protocol and an active comparator new-user design, the study compared the risk of incident dementia among patients initiating different antihypertensive drug classes, with ACE inhibitors (ACEIs) as the reference. The primary outcome was all-cause dementia, with secondary outcomes including Alzheimer’s disease (AD) and vascular dementia (VaD).

Results: Among 1.93 million individuals followed for a median of 5.6 to 8.4 years, initiation with angiotensin-II receptor blockers (ARBs) was associated with a reduced risk of all-cause dementia (hazard ratio [HR], 0.92; 95% confidence interval [CI], 0.89–0.94) and VaD (HR, 0.87; 95% CI, 0.78–0.96) compared with ACEIs. No significant difference was observed for AD.

Clinical impact: These findings suggest that ARBs may offer cognitive protection, particularly against vascular dementia, and should be considered in antihypertensive treatment decisions, especially in patients at elevated dementia risk.

Source:

Cheung ECL, et al. (2025, May 25). Age Ageing. Antihypertensive drug classes and risk of incident dementia: a multinational population-based cohort study. https://pubmed.ncbi.nlm.nih.gov/40413804/