德国一般实践中抗高血压药物的使用与痴呆症发病率之间的关系。

The Relationship Between the Use of Antihypertensive Drugs and the Incidence of Dementia in General Practices in Germany.

机构信息

Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät der Universität Leipzig, Germany.

Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France.

出版信息

J Alzheimers Dis. 2019;70(1):91-97. doi: 10.3233/JAD-190362.

DOI:10.3233/JAD-190362

PMID:31127790

Abstract

BACKGROUND

In recent years, there has been a growing interest in the association between the use of antihypertensive drugs and the incidence of dementia.

OBJECTIVE

The goal of this retrospective study was to investigate the relationship between antihypertensive drug use and dementia in elderly persons followed in general practices in Germany.

METHODS

This study included patients ≥60 years with documented blood pressure values who were diagnosed with dementia in general practices in Germany for the first time between 2013 and 2017 (index date). Dementia cases were matched to non-dementia controls using propensity scores based on age, sex, index year, and co-diagnoses. The main outcome of the study was the incidence of dementia as a function of the use of antihypertensive drugs.

RESULTS

The present study included 12,405 patients with dementia and 12,405 patients without dementia. The use of angiotensin II receptor blockers (odds ratios [ORs] ranging from 0.74 to 0.79), angiotensin-converting enzyme inhibitors (ORs ranging from 0.85 to 0.88), calcium channel blockers (ORs ranging from 0.82 to 0.89), and beta blockers (OR = 0.88) was associated with a decrease in dementia incidence.

CONCLUSION

Antihypertensive drug use is negatively associated with dementia in elderly persons followed in general practices in Germany.

摘要

背景

近年来，人们对降压药物的使用与痴呆症发病率之间的关联越来越感兴趣。

目的

本回顾性研究旨在探讨德国普通诊所中使用降压药物与老年人群痴呆症之间的关系。

方法

本研究纳入了 2013 年至 2017 年期间首次在德国普通诊所被诊断为痴呆症的年龄≥60 岁、有明确血压值记录的患者（索引日期）。采用倾向评分，根据年龄、性别、索引年和合并诊断，将痴呆症病例与非痴呆症对照进行匹配。研究的主要结局是根据降压药物的使用情况，评估痴呆症的发病率。

结果

本研究纳入了 12405 例痴呆症患者和 12405 例非痴呆症患者。使用血管紧张素 II 受体阻滞剂（比值比 [OR] 范围为 0.74 至 0.79）、血管紧张素转换酶抑制剂（OR 范围为 0.85 至 0.88）、钙通道阻滞剂（OR 范围为 0.82 至 0.89）和β受体阻滞剂（OR=0.88）与痴呆症发病率降低相关。