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Beta-blocker therapy and risk of vascular dementia : A population-based prospective study

Holm, H LU ; Ricci, F LU ; Di Martino, G ; Bachus, E LU ; Nilsson, E D ; Ballerini, P ; Melander, O LU orcid ; Hansson, O LU orcid ; Nägga, K LU and Magnusson, M LU orcid , et al. (2020) In Vascular Pharmacology 125-126.
Abstract

There are a few studies that report cognitive impairment as a complication of treatment with beta- blockers. We aimed to evaluate the longitudinal association between use of beta-blockers, as a class, and incident risk of all-cause dementia, vascular dementia, Alzheimer's and mixed dementia in the prospective population-based Malmö Preventive Project. We included 18,063 individuals (mean age 68.2, males 63.4%) followed up for 84,506 person-years. Dementia cases were retrieved from the Swedish National Patient Register and validated by review of medical records and neuroimaging data. We performed propensity score matching analysis, resulting in 3720 matched pairs of beta-blocker users and non-users at baseline, and multivariable Cox... (More)

There are a few studies that report cognitive impairment as a complication of treatment with beta- blockers. We aimed to evaluate the longitudinal association between use of beta-blockers, as a class, and incident risk of all-cause dementia, vascular dementia, Alzheimer's and mixed dementia in the prospective population-based Malmö Preventive Project. We included 18,063 individuals (mean age 68.2, males 63.4%) followed up for 84,506 person-years. Dementia cases were retrieved from the Swedish National Patient Register and validated by review of medical records and neuroimaging data. We performed propensity score matching analysis, resulting in 3720 matched pairs of beta-blocker users and non-users at baseline, and multivariable Cox proportional-hazards regression. Overall, 122 study participants (1.6%) were diagnosed with dementia during the follow-up. Beta-blocker therapy was independently associated with increased risk of developing vascular dementia, regardless of confounding factors (HR: 1.72, 95%CI 1.01-3.78; p = .048). Conversely, treatment with beta-blockers was not associated with increased risk of all-cause, Alzheimer's and mixed dementia (HR:1.15; 95%CI 0.80-1.66; p = .44; HR:0.85; 95%CI 0.48-1.54; P = .59 and HR:1.35; 95%CI 0.56-3.27; p = .50, respectively). We observed that use of beta-blockers, as a class, is associated with increased longitudinal risk of vascular dementia in the general elderly population, regardless of cardiovascular risk factors, prevalent or incident history of atrial fibrillation, stroke, coronary events and heart failure. Further studies are needed to confirm our findings in the general population and to explore the mechanisms underlying the relationship between use of beta- blockers and increased risk of vascular dementia.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Vascular Pharmacology
volume
125-126
article number
106649
publisher
Elsevier
external identifiers
  • pmid:31958512
  • scopus:85078215328
ISSN
1537-1891
DOI
10.1016/j.vph.2020.106649
language
English
LU publication?
yes
additional info
Copyright © 2019. Published by Elsevier Inc.
id
a2e807f4-ef05-43af-a231-ed09f5d6c642
date added to LUP
2020-01-22 00:10:32
date last changed
2024-05-29 06:37:43
@article{a2e807f4-ef05-43af-a231-ed09f5d6c642,
  abstract     = {{<p>There are a few studies that report cognitive impairment as a complication of treatment with beta- blockers. We aimed to evaluate the longitudinal association between use of beta-blockers, as a class, and incident risk of all-cause dementia, vascular dementia, Alzheimer's and mixed dementia in the prospective population-based Malmö Preventive Project. We included 18,063 individuals (mean age 68.2, males 63.4%) followed up for 84,506 person-years. Dementia cases were retrieved from the Swedish National Patient Register and validated by review of medical records and neuroimaging data. We performed propensity score matching analysis, resulting in 3720 matched pairs of beta-blocker users and non-users at baseline, and multivariable Cox proportional-hazards regression. Overall, 122 study participants (1.6%) were diagnosed with dementia during the follow-up. Beta-blocker therapy was independently associated with increased risk of developing vascular dementia, regardless of confounding factors (HR: 1.72, 95%CI 1.01-3.78; p = .048). Conversely, treatment with beta-blockers was not associated with increased risk of all-cause, Alzheimer's and mixed dementia (HR:1.15; 95%CI 0.80-1.66; p = .44; HR:0.85; 95%CI 0.48-1.54; P = .59 and HR:1.35; 95%CI 0.56-3.27; p = .50, respectively). We observed that use of beta-blockers, as a class, is associated with increased longitudinal risk of vascular dementia in the general elderly population, regardless of cardiovascular risk factors, prevalent or incident history of atrial fibrillation, stroke, coronary events and heart failure. Further studies are needed to confirm our findings in the general population and to explore the mechanisms underlying the relationship between use of beta- blockers and increased risk of vascular dementia.</p>}},
  author       = {{Holm, H and Ricci, F and Di Martino, G and Bachus, E and Nilsson, E D and Ballerini, P and Melander, O and Hansson, O and Nägga, K and Magnusson, M and Fedorowski, A}},
  issn         = {{1537-1891}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Vascular Pharmacology}},
  title        = {{Beta-blocker therapy and risk of vascular dementia : A population-based prospective study}},
  url          = {{http://dx.doi.org/10.1016/j.vph.2020.106649}},
  doi          = {{10.1016/j.vph.2020.106649}},
  volume       = {{125-126}},
  year         = {{2020}},
}