Jan. 8, 2013 -- SAN DIEGO -- Drugs designed to lower blood pressure seem to reduce the risk of dementia and Alzheimer's disease, according to a study in older Japanese-American men.
Autopsies on 774 men showed that those who had taken beta-blockers for hypertension had significantly fewer microinfarctions, less brain atrophy, and fewer Alzheimer's lesions in the brain than those who had been treated with other medications, according to Dr. Lon White of the Pacific Health Research and Education Institute in Honolulu and colleagues.
Although beta-blockers alone were superior to other forms of treatment, any drug treatment was better for dementia- and Alzheimer's-related damage than no drug treatment, according to an abstract of a study that will be reported at the American Academy of Neurology meeting.
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The researchers noted that a systolic blood pressure greater than 120 mm Hg in midlife predicted the population attributable risk of dementia in 17 percent to 27 percent of cases.
The study looked at the relationship between brain lesions at autopsy with beta-blocker treatment compared with other antihypertensive drugs.
The participants, ages 71 to 93, were enrolled in the Honolulu-Asia Aging Study from 1991 to 2012. Of the 774, 610 had been hypertensive or treated with antihypertensive drugs.
Among those receiving treatment, 15 percent received only a beta-blocker, 18 percent received a beta-blocker and one or more other medications, and the remaining 67 percent received other blood pressure medications.
Results were adjusted for age, baseline blood pressures, baseline cognitive test score, follow-up interval, age at death, diabetes, apolipoprotein E genotype, midlife hypertension, and whether or not midlife hypertension was treated.
Participants who received only beta-blockers had significantly fewer microinfarctions and Alzheimer brain lesions than those who received no treatment or non-beta-blocker treatment.
Those who received beta-blocker therapy in combination with other blood pressure drugs had an "intermediate reduction in numbers of brain abnormalities."
Patients who received beta-blocker therapy -- alone or in combination with other blood pressure drugs -- had significantly less brain atrophy than those who received no or alternative treatment.
The study showed "a congruent amelioration of cognitive decline or impairment associated with beta-blocker use," the authors concluded.
However, the relationship may not be causal, noted Mary Sano of Mount Sinai Medical Center in New York City.
"I think we have to recognize that it's possible that people who needed only one drug -- the beta-blockers -- may have had less disease to begin with," said Sano, who was not involved in the study. "They may look like they're better not because of the drug, but because of a less severe underlying condition."
"I think that the important take-away message is to put together the best treatment for the condition at hand," she added.