Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

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 orcid ; 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)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
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
Elsevier
external identifiers
  • wos:000292036600009
  • scopus:79959744308
  • pmid:21457948
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
2016-04-01 11:05:00
date last changed
2022-02-10 08:36:45
@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}},
  keywords     = {{Alzheimer's disease; antihypertensive therapy; antihypertensive; treatment; microcirculatory function; mild cognitive impairment; MR-proANP}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{145--151}},
  publisher    = {{Elsevier}},
  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}},
  doi          = {{10.1016/j.biopsych.2011.01.036}},
  volume       = {{70}},
  year         = {{2011}},
}