Antihypertensive medication is associated with less cognitive impairment in the very old with apolipoprotein-E epsilon4 allele

Drugs Aging. 2006;23(9):723-31. doi: 10.2165/00002512-200623090-00002.

Abstract

Background and objectives: High and low blood pressure and apolipoprotein (Apo)-E epsilon4 alleles have been shown to be associated with dementia of the Alzheimer's type. The aim of this study was to examine the relationship between Apo-E epsilon4 allele status and the effect of antihypertensive treatment on cognitive performance in persons > or =80 years of age.

Methods: A sample of 258 individuals 80-102 years of age was studied. Associations between the Mini-Mental State Examination (MMSE) score and treatment with antihypertensive medication, blood pressure, Apo-E polymorphism, sex, age and education were assessed. Patients treated with antihypertensive drugs typically used two to ten different medications.

Results: Individuals with no Apo-E epsilon4 alleles who were not treated with antihypertensive medications had a significantly higher diastolic blood pressure than other participants in the study but no cognitive deficits. Participants who had at least one Apo-E epsilon4 allele who were not treated with antihypertensive medications scored significantly lower on the MMSE compared with other participants in the study.

Conclusions: Individuals with an Apo-E epsilon4 allele who were not treated with antihypertensive medication showed the poorest cognitive performance. This could suggest that individuals with the Apo-E epsilon4 allele may benefit cognitively from treatment with antihypertensive drugs.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Antihypertensive Agents / administration & dosage
  • Antihypertensive Agents / adverse effects*
  • Antihypertensive Agents / pharmacology
  • Antihypertensive Agents / therapeutic use
  • Apolipoproteins E / genetics*
  • Cognition / drug effects*
  • Cognition Disorders / etiology
  • Cognition Disorders / genetics*
  • Female
  • Genetic Predisposition to Disease*
  • Humans
  • Hypertension / drug therapy
  • Male
  • Mental Status Schedule
  • Treatment Outcome

Substances

  • Antihypertensive Agents
  • Apolipoproteins E