Abstract Details

Title Beta Blocker Treatment of Hypertensive Older Persons Ameliorates the Brain Lesions of Dementia Measured at Autopsy: The Honolulu-Asia Aging Study

Topic Aging and Dementia

Presentation(s) S44 - (-)

Poster/Presentation
Number 005

Objective

Background The HAAS is a community-based study of Japanese-American men aged 71-93 at baseline, conducted 1991-2012. Prior analyses identified elevated midlife blood pressure as a risk factor for Alzheimer's disease, cognitive impairment, and Alzheimer brain lesions at autopsy. Midlife systolic pressure >120mm Hg was a predictor for 17-27% (population attributable risk) of subsequent dementia cases. While angiotensin receptor blockers and other treatments have been reported to reduce the development of dementia, comparisons with beta blockers are lacking. A concurrent analysis in HAAS subjects demonstrates a congruent amelioration of cognitive decline or impairment associated with beta blocker use, including but not limited to participants described in this report.

Design/Methods Of 774 autopsied men, 610 had been hypertensive or treated with anti-hypertensive drugs. Logistic and linear regression analyses took into account non-normal neuropathologic endpoint distributions while adjusting for age, baseline pressures and cognitive test score, follow-up interval, age at death, diabetes, apolipoprotein E genotype, midlife hypertension and treatment thereof.

Results Autopsied HAAS subjects treated with beta blockers as the sole medication were found to have significantly fewer microinfarcts, less brain atrophy, and fewer Alzheimer brain lesions compared with decedents who had received other medications. Those who had received beta blockers plus other medications had intermediate or marginally fewer brain abnormalities.

Conclusions Compared with other treatments, beta blocker use in HAAS participants was associated with lower levels of neuropathologic abnormalities associated with cognitive impairment and dementia.

Authors/Disclosures
Lon R. White, MD PRESENTER	No disclosure on file
Rebecca Gelber	No disclosure on file
Lenore J. Launer, PhD (National Institute on Aging)	No disclosure on file
Lawrence D. Recht, MD, FAAN (Stanford Cancer Center)	No disclosure on file
	No disclosure on file
Joshua A. Sonnen	No disclosure on file
Jane Uyehara-Lock, MD (John A. Burns School of Medicine, University of Hawaii at Manoa)	No disclosure on file
Kamal Masaki, MD	No disclosure on file
Web Ross, MD (Pacific Health Research and ��ɫ�� Institute)	The institution of Dr. Ross has received research support from Michael J Fox Foundation. The institution of Dr. Ross has received research support from NIH.
Helen Petrovitch, MD (Pacific Health Research Institute)	No disclosure on file
Frank Dahlke, MD, PhD	Dr. Dahlke has received personal compensation for serving as an employee of Novartis.

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