Effects of cardiovascular pharmacotherapies on incident dementia in patients with atrial fibrillation : A cohort study of all patients above 45 years diagnosed with AF in hospitals in Sweden
(2019) In International Journal of Cardiology 297. p.55-60- Abstract
Background: Patients with atrial fibrillation (AF) have an increased dementia risk dementia. We aimed to study the effect of antihypertensive drugs on dementia in AF patients. Methods: Included patients were ≥45 years diagnosed with AF in Swedish National Patient Register (n = 160,251; 89,723 men and 70,528 women) and alive on January 1, 2007. We excluded patients with dementia before onset of AF. Cox regression was used (hazard ratios, HRs, and 99% confidence interval, CI) with adjustments for sex, age, socioeconomic factors and co-morbidities, using incident dementia diagnosis until December 31, 2015 as outcome. Cardiovascular pharmacotherapies were obtained from the Swedish Prescribed Drug Register. Results: Incident dementia... (More)
Background: Patients with atrial fibrillation (AF) have an increased dementia risk dementia. We aimed to study the effect of antihypertensive drugs on dementia in AF patients. Methods: Included patients were ≥45 years diagnosed with AF in Swedish National Patient Register (n = 160,251; 89,723 men and 70,528 women) and alive on January 1, 2007. We excluded patients with dementia before onset of AF. Cox regression was used (hazard ratios, HRs, and 99% confidence interval, CI) with adjustments for sex, age, socioeconomic factors and co-morbidities, using incident dementia diagnosis until December 31, 2015 as outcome. Cardiovascular pharmacotherapies were obtained from the Swedish Prescribed Drug Register. Results: Incident dementia occurred in 9532 patients (5.9%), 4669 men (5.2%) and 4863 women (6.9%). ARBs were associated with lower risk for all patients (HR 0.87, 99% CI 0.78–0.98), especially in the ages 65–84 years of age (HR 0.87, 99% CI 0.76–0.99). Loop-diuretics were associated with higher risk for all dementia among patients 65–84 years of age (HR 1.16, 99% CI 1.00–1.35), and in the sub-group of other causes of dementia than Alzheimer Disease (AD) and vascular dementia (VaD) (HR 1.14, 99% CI 1.00–1.30), but with a lower risk in the sub-group of AD and VaD (HR 0.81, 99% CI 0.68–0.95). Conclusion: ARBs were associated with a decreased incidence of dementia, and loop diuretics with a higher risk in general but lower risk in the AD and VaD sub-group. ARBs could have specific advantages in prevention of dementia, but the results need confirmation in further studies.
(Less)
- author
- Wändell, Per LU ; Carlsson, Axel C. ; Li, Xinjun LU ; Sundquist, Jan LU and Sundquist, Kristina LU
- organization
- publishing date
- 2019
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Antihypertensive drugs, Atrial fibrillation, Dementia, Gender, Hypertension
- in
- International Journal of Cardiology
- volume
- 297
- pages
- 55 - 60
- publisher
- Elsevier
- external identifiers
-
- scopus:85073157365
- pmid:31619361
- ISSN
- 0167-5273
- DOI
- 10.1016/j.ijcard.2019.09.065
- language
- English
- LU publication?
- yes
- id
- 1fc92f0e-4cbf-43ab-9f0f-c39779341305
- date added to LUP
- 2019-10-25 12:01:11
- date last changed
- 2024-09-19 12:02:58
@article{1fc92f0e-4cbf-43ab-9f0f-c39779341305, abstract = {{<p>Background: Patients with atrial fibrillation (AF) have an increased dementia risk dementia. We aimed to study the effect of antihypertensive drugs on dementia in AF patients. Methods: Included patients were ≥45 years diagnosed with AF in Swedish National Patient Register (n = 160,251; 89,723 men and 70,528 women) and alive on January 1, 2007. We excluded patients with dementia before onset of AF. Cox regression was used (hazard ratios, HRs, and 99% confidence interval, CI) with adjustments for sex, age, socioeconomic factors and co-morbidities, using incident dementia diagnosis until December 31, 2015 as outcome. Cardiovascular pharmacotherapies were obtained from the Swedish Prescribed Drug Register. Results: Incident dementia occurred in 9532 patients (5.9%), 4669 men (5.2%) and 4863 women (6.9%). ARBs were associated with lower risk for all patients (HR 0.87, 99% CI 0.78–0.98), especially in the ages 65–84 years of age (HR 0.87, 99% CI 0.76–0.99). Loop-diuretics were associated with higher risk for all dementia among patients 65–84 years of age (HR 1.16, 99% CI 1.00–1.35), and in the sub-group of other causes of dementia than Alzheimer Disease (AD) and vascular dementia (VaD) (HR 1.14, 99% CI 1.00–1.30), but with a lower risk in the sub-group of AD and VaD (HR 0.81, 99% CI 0.68–0.95). Conclusion: ARBs were associated with a decreased incidence of dementia, and loop diuretics with a higher risk in general but lower risk in the AD and VaD sub-group. ARBs could have specific advantages in prevention of dementia, but the results need confirmation in further studies.</p>}}, author = {{Wändell, Per and Carlsson, Axel C. and Li, Xinjun and Sundquist, Jan and Sundquist, Kristina}}, issn = {{0167-5273}}, keywords = {{Antihypertensive drugs; Atrial fibrillation; Dementia; Gender; Hypertension}}, language = {{eng}}, pages = {{55--60}}, publisher = {{Elsevier}}, series = {{International Journal of Cardiology}}, title = {{Effects of cardiovascular pharmacotherapies on incident dementia in patients with atrial fibrillation : A cohort study of all patients above 45 years diagnosed with AF in hospitals in Sweden}}, url = {{http://dx.doi.org/10.1016/j.ijcard.2019.09.065}}, doi = {{10.1016/j.ijcard.2019.09.065}}, volume = {{297}}, year = {{2019}}, }