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Antihypertensive Therapy Is Associated with Reduced Rate of Conversion to Alzheimer's Disease in Midregional Proatrial Natriuretic Peptide Stratified Subjects with Mild Cognitive Impairment

Schneider, Philine; Buerger, Katharina; Teipel, Stefan; Uspenskaya, Olga; Hartmann, Oliver; Hansson, Oskar LU ; Minthon, Lennart LU ; Rujescu, Dan; Moeller, Hans-juergen and Zetterberg, Henrik, et al. (2011) In Biological Psychiatry 70(2). p.145-151
Abstract
Background: Hypertension is a major risk factor of Alzheimer's disease (AD); however, controlled studies on the effect of antihypertensive treatment on the risk of dementia are inconclusive. Therefore, a biological marker that predicts individual response to antihypertensive treatment would be of high clinical relevance. Midregional proatrial natriuretic peptide (MR-proANP), an inactive surrogate molecule of the mature atrial natriuretic peptide, is related to circulatory function and hypertension. Methods: A sample population of 134 subjects with mild cognitive impairment (MCI) was followed for up to 6 years. Multivariable Cox regression analysis was conducted to predict conversion to AD based on all relevant variables. Results: Baseline... (More)
Background: Hypertension is a major risk factor of Alzheimer's disease (AD); however, controlled studies on the effect of antihypertensive treatment on the risk of dementia are inconclusive. Therefore, a biological marker that predicts individual response to antihypertensive treatment would be of high clinical relevance. Midregional proatrial natriuretic peptide (MR-proANP), an inactive surrogate molecule of the mature atrial natriuretic peptide, is related to circulatory function and hypertension. Methods: A sample population of 134 subjects with mild cognitive impairment (MCI) was followed for up to 6 years. Multivariable Cox regression analysis was conducted to predict conversion to AD based on all relevant variables. Results: Baseline MR-proANP was significantly increased in the AD converter group (p < .0001). The conversion rate of patients treated with antihypertensive drugs was significantly reduced only in patients with elevated MR-proANP at baseline (p = .046). Using an optimized MR-proANP cutoff of 74 pmol/L, representing a value in the upper normal range, treatment with antihypertensive drugs reduced the conversion rate to AD by 36% (p = .035) for patients with levels > 74 pmol/L. Further subgrouping by age (>/<= 72 years at baseline) increased the positive correlation of antihypertensive treatment and MCI outcome for patients below the age of 72 years (conversion rate reduced by 74%, p = .016). Conclusions: These data seem to support the notion of a potential impact of circulatory function for the prognosis of AD at a prodromal stage. The MR-proANP levels may be useful to predict the effect of antihypertensive treatment on conversion rates to AD in subjects with MCI. (Less)
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published
subject
keywords
Alzheimer's disease, antihypertensive therapy, antihypertensive, treatment, microcirculatory function, mild cognitive impairment, MR-proANP
in
Biological Psychiatry
volume
70
issue
2
pages
145 - 151
publisher
Society of Biological Psychiatry Published by Elsevier Inc.
external identifiers
  • wos:000292036600009
  • scopus:79959744308
ISSN
0006-3223
DOI
10.1016/j.biopsych.2011.01.036
language
English
LU publication?
yes
id
0b04da29-cd3e-4ad7-ada0-daae1be4ce3d (old id 2049260)
date added to LUP
2011-08-02 08:59:39
date last changed
2017-07-02 03:23:37
@article{0b04da29-cd3e-4ad7-ada0-daae1be4ce3d,
  abstract     = {Background: Hypertension is a major risk factor of Alzheimer's disease (AD); however, controlled studies on the effect of antihypertensive treatment on the risk of dementia are inconclusive. Therefore, a biological marker that predicts individual response to antihypertensive treatment would be of high clinical relevance. Midregional proatrial natriuretic peptide (MR-proANP), an inactive surrogate molecule of the mature atrial natriuretic peptide, is related to circulatory function and hypertension. Methods: A sample population of 134 subjects with mild cognitive impairment (MCI) was followed for up to 6 years. Multivariable Cox regression analysis was conducted to predict conversion to AD based on all relevant variables. Results: Baseline MR-proANP was significantly increased in the AD converter group (p &lt; .0001). The conversion rate of patients treated with antihypertensive drugs was significantly reduced only in patients with elevated MR-proANP at baseline (p = .046). Using an optimized MR-proANP cutoff of 74 pmol/L, representing a value in the upper normal range, treatment with antihypertensive drugs reduced the conversion rate to AD by 36% (p = .035) for patients with levels &gt; 74 pmol/L. Further subgrouping by age (&gt;/&lt;= 72 years at baseline) increased the positive correlation of antihypertensive treatment and MCI outcome for patients below the age of 72 years (conversion rate reduced by 74%, p = .016). Conclusions: These data seem to support the notion of a potential impact of circulatory function for the prognosis of AD at a prodromal stage. The MR-proANP levels may be useful to predict the effect of antihypertensive treatment on conversion rates to AD in subjects with MCI.},
  author       = {Schneider, Philine and Buerger, Katharina and Teipel, Stefan and Uspenskaya, Olga and Hartmann, Oliver and Hansson, Oskar and Minthon, Lennart and Rujescu, Dan and Moeller, Hans-juergen and Zetterberg, Henrik and Blennow, Kaj and Ernst, Andrea and Bergmann, Andreas and Hampel, Harald},
  issn         = {0006-3223},
  keyword      = {Alzheimer's disease,antihypertensive therapy,antihypertensive,treatment,microcirculatory function,mild cognitive impairment,MR-proANP},
  language     = {eng},
  number       = {2},
  pages        = {145--151},
  publisher    = {Society of Biological Psychiatry Published by Elsevier Inc.},
  series       = {Biological Psychiatry},
  title        = {Antihypertensive Therapy Is Associated with Reduced Rate of Conversion to Alzheimer's Disease in Midregional Proatrial Natriuretic Peptide Stratified Subjects with Mild Cognitive Impairment},
  url          = {http://dx.doi.org/10.1016/j.biopsych.2011.01.036},
  volume       = {70},
  year         = {2011},
}