Neuroprotective effect of angiotensin II receptor blockers on the risk of incident Alzheimer's disease: A nationwide population-based cohort study
被引:19
作者:
Lee, Hyun Woo
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Yonsei Univ, Coll Med, Dept Pharmaceut Med & Regulatory Sci, Incheon, South Korea
Yonsei Univ, Coll Pharm, Dept Pharmaceut Med & Regulatory Sci, Incheon, South Korea
Yonsei Univ, Coll Pharm, Dept Pharm, Incheon, South Korea
Yonsei Univ, Yonsei Inst Pharmaceut Sci, Coll Pharm, Incheon, South KoreaYonsei Univ, Coll Med, Dept Pharmaceut Med & Regulatory Sci, Incheon, South Korea
Lee, Hyun Woo
[1
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,4
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Kim, Seungyeon
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Dankook Univ, Coll Pharm, Cheonan, South KoreaYonsei Univ, Coll Med, Dept Pharmaceut Med & Regulatory Sci, Incheon, South Korea
Kim, Seungyeon
[5
]
Jo, Youngkwon
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Yonsei Univ, Coll Pharm, Dept Pharm, Incheon, South Korea
Yonsei Univ, Yonsei Inst Pharmaceut Sci, Coll Pharm, Incheon, South KoreaYonsei Univ, Coll Med, Dept Pharmaceut Med & Regulatory Sci, Incheon, South Korea
Jo, Youngkwon
[3
,4
]
Kim, Youjin
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Yonsei Univ, Coll Pharm, Dept Pharm, Incheon, South Korea
Yonsei Univ, Yonsei Inst Pharmaceut Sci, Coll Pharm, Incheon, South KoreaYonsei Univ, Coll Med, Dept Pharmaceut Med & Regulatory Sci, Incheon, South Korea
Kim, Youjin
[3
,4
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Ye, Byoung Seok
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Yonsei Univ, Coll Med, Dept Neurol, Seoul, South KoreaYonsei Univ, Coll Med, Dept Pharmaceut Med & Regulatory Sci, Incheon, South Korea
Ye, Byoung Seok
[6
]
Yu, Yun Mi
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Yonsei Univ, Coll Med, Dept Pharmaceut Med & Regulatory Sci, Incheon, South Korea
Yonsei Univ, Coll Pharm, Dept Pharmaceut Med & Regulatory Sci, Incheon, South Korea
Yonsei Univ, Coll Pharm, Dept Pharm, Incheon, South Korea
Yonsei Univ, Yonsei Inst Pharmaceut Sci, Coll Pharm, Incheon, South KoreaYonsei Univ, Coll Med, Dept Pharmaceut Med & Regulatory Sci, Incheon, South Korea
Yu, Yun Mi
[1
,2
,3
,4
]
机构:
[1] Yonsei Univ, Coll Med, Dept Pharmaceut Med & Regulatory Sci, Incheon, South Korea
[2] Yonsei Univ, Coll Pharm, Dept Pharmaceut Med & Regulatory Sci, Incheon, South Korea
[3] Yonsei Univ, Coll Pharm, Dept Pharm, Incheon, South Korea
[4] Yonsei Univ, Yonsei Inst Pharmaceut Sci, Coll Pharm, Incheon, South Korea
[5] Dankook Univ, Coll Pharm, Cheonan, South Korea
[6] Yonsei Univ, Coll Med, Dept Neurol, Seoul, South Korea
BackgroundRecent studies on renin-angiotensin system (RAS) inhibitors have reported a reduced risk of Alzheimer's disease (AD). Nevertheless, the effect of RAS inhibitor type and blood-brain barrier (BBB) permeability on the risk of AD is still unknown. ObjectivesTo assess the effects of RAS inhibitors on the risk of AD based on the type and BBB permeability and investigate the cumulative duration-response relationship. MethodsThis was a population-based retrospective cohort study using the Korean Health Insurance Review and Assessment database records from 2008 to 2019. The data of patients diagnosed with ischemic heart disease between January 2009 and June 2009 were identified for inclusion in the analyses. Propensity score matching was used to balance RAS inhibitor users with non-users. The association between the use of RAS inhibitors and incident AD was evaluated using a multivariate Cox proportional hazard regression model. The results are presented in adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). ResultsAmong the 57,420 matched individuals, 7,303 developed AD within the follow-up period. While the use of angiotensin-converting enzyme inhibitors (ACEIs) was not significantly associated with AD risk, the use of angiotensin II receptor blockers (ARBs) showed a significant association with reduced risk of incident AD (aHR = 0.94; 95% CI = 0.90-0.99). Furthermore, the use of BBB-crossing ARBs was associated with a lower risk of AD (aHR = 0.83; 95% CI = 0.78-0.88) with a cumulative duration-response relationship. A higher cumulative dose or duration of BBB-crossing ARBs was associated with a gradual decrease in AD risk (P for trend < 0.001). No significant association between the use of ACEIs and the risk of AD was observed regardless of BBB permeability. ConclusionLong-term use of BBB-crossing ARBs significantly reduced the risk of AD development. The finding may provide valuable insight into disease-modifying drug options for preventing AD in patients with cardiovascular diseases.
机构:
Banner Hlth, Banner Sun Hlth Res Inst, 10515 W Santa Fe Dr, Sun City, AZ 85351 USA
Brigham & Womens Hosp, Dept Neurol, 60 Fenwood Rd, Boston, MA 02115 USA
Harvard Med Sch, 25 Shattuck St, Boston, MA 02115 USA
Banner Sun Hlth Res Inst, 10515 W Santa Fe Dr, Sun City, AZ 85351 USABanner Hlth, Banner Sun Hlth Res Inst, 10515 W Santa Fe Dr, Sun City, AZ 85351 USA
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Kings Coll London, Wolfson Ctr Age Related Dis, London SE1 1UL, EnglandKings Coll London, Wolfson Ctr Age Related Dis, London SE1 1UL, England
Ballard, Clive
Gauthier, Serge
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Douglas Mental Hlth Res Inst, McGill Ctr Studies Aging, Montreal, PQ, CanadaKings Coll London, Wolfson Ctr Age Related Dis, London SE1 1UL, England
Gauthier, Serge
Corbett, Anne
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Alzheimers Soc, London, EnglandKings Coll London, Wolfson Ctr Age Related Dis, London SE1 1UL, England
Corbett, Anne
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Brayne, Carol
Aarsland, Dag
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Univ Hosp Stavanger, Stavanger, NorwayKings Coll London, Wolfson Ctr Age Related Dis, London SE1 1UL, England
Aarsland, Dag
Jones, Emma
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Kings Coll London, Wolfson Ctr Age Related Dis, London SE1 1UL, EnglandKings Coll London, Wolfson Ctr Age Related Dis, London SE1 1UL, England
机构:
Banner Hlth, Banner Sun Hlth Res Inst, 10515 W Santa Fe Dr, Sun City, AZ 85351 USA
Brigham & Womens Hosp, Dept Neurol, 60 Fenwood Rd, Boston, MA 02115 USA
Harvard Med Sch, 25 Shattuck St, Boston, MA 02115 USA
Banner Sun Hlth Res Inst, 10515 W Santa Fe Dr, Sun City, AZ 85351 USABanner Hlth, Banner Sun Hlth Res Inst, 10515 W Santa Fe Dr, Sun City, AZ 85351 USA
机构:
Kings Coll London, Wolfson Ctr Age Related Dis, London SE1 1UL, EnglandKings Coll London, Wolfson Ctr Age Related Dis, London SE1 1UL, England
Ballard, Clive
Gauthier, Serge
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机构:
Douglas Mental Hlth Res Inst, McGill Ctr Studies Aging, Montreal, PQ, CanadaKings Coll London, Wolfson Ctr Age Related Dis, London SE1 1UL, England
Gauthier, Serge
Corbett, Anne
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Alzheimers Soc, London, EnglandKings Coll London, Wolfson Ctr Age Related Dis, London SE1 1UL, England
Corbett, Anne
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Brayne, Carol
Aarsland, Dag
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Univ Hosp Stavanger, Stavanger, NorwayKings Coll London, Wolfson Ctr Age Related Dis, London SE1 1UL, England
Aarsland, Dag
Jones, Emma
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Kings Coll London, Wolfson Ctr Age Related Dis, London SE1 1UL, EnglandKings Coll London, Wolfson Ctr Age Related Dis, London SE1 1UL, England