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dc.contributor.authorLi, Nien-Chenen_US
dc.contributor.authorLee, Austinen_US
dc.contributor.authorWhitmer, Rachel Aen_US
dc.contributor.authorKivipelto, Miiaen_US
dc.contributor.authorLawler, Elizabethen_US
dc.contributor.authorKazis, Lewis Een_US
dc.contributor.authorWolozin, Benjaminen_US
dc.date.accessioned2012-01-11T21:07:25Z
dc.date.available2012-01-11T21:07:25Z
dc.date.copyright2010en_US
dc.date.issued2010-1-12en_US
dc.identifier.citationLi, Nien-Chen, Austin Lee, Rachel A Whitmer, Miia Kivipelto, Elizabeth Lawler, Lewis E Kazis, Benjamin Wolozin. "Use of angiotensin receptor blockers and risk of dementia in a predominantly male population: prospective cohort analysis" BMJ: British Medical Journal 340:b5465. (2010)en_US
dc.identifier.issn1468-5833en_US
dc.identifier.urihttp://hdl.handle.net/2144/3169
dc.description.abstractObjective To investigate whether angiotensin receptor blockers protect against Alzheimer's disease and dementia or reduce the progression of both diseases. Design Prospective cohort analysis. Setting Administrative database of the US Veteran Affairs, 2002-6. Population 819491 predominantly male participants (98%) aged 65 or more with cardiovascular disease. Main outcome measures Time to incident Alzheimer's disease or dementia in three cohorts (angiotensin receptor blockers, lisinopril, and other cardiovascular drugs, the "cardiovascular comparator") over a four year period (fiscal years 2003-6) using Cox proportional hazard models with adjustments for age, diabetes, stroke, and cardiovascular disease. Disease progression was the time to admission to a nursing home or death among participants with pre-existing Alzheimer's disease or dementia. Results Hazard rates for incident dementia in the angiotensin receptor blocker group were 0.76 (95% confidence interval 0.69 to 0.84) compared with the cardiovascular comparator and 0.81 (0.73 to 0.90) compared with the lisinopril group. Compared with the cardiovascular comparator, angiotensin receptor blockers in patients with pre-existing Alzheimer's disease were associated with a significantly lower risk of admission to a nursing home (0.51, 0.36 to 0.72) and death (0.83, 0.71 to 0.97). Angiotensin receptor blockers exhibited a dose-response as well as additive effects in combination with angiotensin converting enzyme inhibitors. This combination compared with angiotensin converting enzyme inhibitors alone was associated with a reduced risk of incident dementia (0.54, 0.51 to 0.57) and admission to a nursing home (0.33, 0.22 to 0.49). Minor differences were shown in mean systolic and diastolic blood pressures between the groups. Similar results were observed for Alzheimer's disease. Conclusions Angiotensin receptor blockers are associated with a significant reduction in the incidence and progression of Alzheimer's disease and dementia compared with angiotensin converting enzyme inhibitors or other cardiovascular drugs in a predominantly male population.en_US
dc.description.sponsorshipRetirement Research Foundation; Casten Foundationen_US
dc.language.isoenen_US
dc.publisherBMJ Publishing Group Ltd.en_US
dc.rightsCopyright Li et al 2010 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.en_US
dc.titleUse of Angiotensin Receptor Blockers and Risk of Dementia in a Predominantly Male Population: Prospective Cohort Analysisen_US
dc.typearticleen_US
dc.identifier.doi10.1136/bmj.b5465en_US
dc.identifier.pubmedid20068258en_US
dc.identifier.pmcid2806632en_US


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