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Association of combination statin and antihypertensive therapy with reduced Alzheimer’s disease and related dementia risk

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  • Douglas Barthold
  • Geoffrey Joyce
  • Roberta Diaz Brinton
  • Whitney Wharton
  • Patrick Gavin Kehoe
  • Julie Zissimopoulos

Abstract

Background: Hyperlipidemia and hypertension are modifiable risk factors for Alzheimer’s disease and related dementias (ADRD). Approximately 25% of adults over age 65 use both antihypertensives (AHTs) and statins for these conditions. While a growing body of evidence found statins and AHTs are independently associated with lower ADRD risk, no evidence exists on simultaneous use for different drug class combinations and ADRD risk. Our primary objective was to compare ADRD risk associated with concurrent use of different combinations of statins and antihypertensives. Methods: In a retrospective cohort study (2007–2014), we analyzed 694,672 Medicare beneficiaries in the United States (2,017,786 person-years) who concurrently used both statins and AHTs. Using logistic regression adjusting for age, socioeconomic status and comorbidities, we quantified incident ADRD diagnosis associated with concurrent use of different statin molecules (atorvastatin, pravastatin, rosuvastatin, and simvastatin) and AHT drug classes (two renin-angiotensin system (RAS)-acting AHTs, angiotensin converting enzyme inhibitors (ACEIs) or angiotensin-II receptor blockers (ARBs), vs non-RAS-acting AHTs). Findings: Pravastatin or rosuvastatin combined with RAS-acting AHTs reduce risk of ADRD relative to any statin combined with non-RAS-acting AHTs: ACEI+pravastatin odds ratio (OR) = 0.942 (CI: 0.899–0.986, p = 0.011), ACEI+rosuvastatin OR = 0.841 (CI: 0.794–0.892, p

Suggested Citation

  • Douglas Barthold & Geoffrey Joyce & Roberta Diaz Brinton & Whitney Wharton & Patrick Gavin Kehoe & Julie Zissimopoulos, 2020. "Association of combination statin and antihypertensive therapy with reduced Alzheimer’s disease and related dementia risk," PLOS ONE, Public Library of Science, vol. 15(3), pages 1-15, March.
    • Handle: RePEc:plo:pone00:0229541
    DOI: 10.1371/journal.pone.0229541
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    References listed on IDEAS

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    1. Douglas Barthold & Geoffrey Joyce & Whitney Wharton & Patrick Kehoe & Julie Zissimopoulos, 2018. "The association of multiple anti-hypertensive medication classes with Alzheimer’s disease incidence across sex, race, and ethnicity," PLOS ONE, Public Library of Science, vol. 13(11), pages 1-18, November.
    2. Zissimopoulos Julie & Crimmins Eileen & St.Clair Patricia, 2015. "The Value of Delaying Alzheimer’s Disease Onset," Forum for Health Economics & Policy, De Gruyter, vol. 18(1), pages 25-39, January.
    3. Julie M ZissimopoulosPhD & Bryan C TysingerMS & Patricia A St.ClairScB & Eileen M CrimminsPhD, 2018. "The Impact of Changes in Population Health and Mortality on Future Prevalence of Alzheimer’s Disease and Other Dementias in the United States," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 73(suppl_1), pages 38-47.
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