Abstract Details

Title Beta-Blocker Treatment of Hypertensive Older Persons Decreases Risk of Cognitive Impairment: The Honolulu-Asia Aging Study

Topic Aging and Dementia

Presentation(s) P03 - (-)

Poster/Presentation
Number 094

Objective

Background BACKGROUND: While hypertension has been shown to increase the risk of dementia and cognitive impairment, the optimal antihypertensive drug class to reduce this risk remains unclear.

Design/Methods DESIGN/METHODS: The Honolulu-Asia Aging Study is a prospective, community-based cohort study of Japanese American men conducted in Honolulu, Hawaii. Included were 2285 participants, ages 71-93, with hypertension and without dementia at cohort entry, who provided information on medication use supplemented by examination of drug containers. Participants were followed through September 2010. Cognitive function was assessed at seven standardized examinations. Cox models were used to estimate incidence rate ratios (IRR) for cognitive impairment (defined as a score <74 on the Cognitive Abilities Screening Instrument) and cognitive decline (decrease in score of ?9 points).

Results RESULTS: A total of 854 men developed cognitive impairment, and 1199 developed cognitive decline (median follow-up, 5.8 years). Beta-blocker use as the sole antihypertensive drug at baseline was consistently associated with a lower risk of cognitive impairment (IRR, 0.69; 95% CI, 0.50-0.94), as compared with men not taking any antihypertensive medications, adjusting for multiple potential confounders. The IRR for cognitive decline was 0.77 (95% CI, 0.61-0.99). Results were similar excluding those with a history of cardiovascular disease (IRR for cognitive impairment, 0.65; 95% CI, 0.46-0.92). The use of diuretics, calcium channel blockers, angiotensin-converting enzyme inhibitors, or vasodilators alone was not significantly associated with cognitive impairment or decline. The association between beta-blocker use and cognitive impairment was stronger among men with diabetes at baseline, those aged >75 years at baseline, and those with baseline pulse pressure >70 mmHg.

Conclusions CONCLUSIONS: Beta-blocker use is associated with a lower risk of developing cognitive impairment and decline in elderly Japanese American men.

Authors/Disclosures
Rebecca Gelber PRESENTER	No disclosure on file
Lenore J. Launer, PhD (National Institute on Aging)	No disclosure on file
Helen Petrovitch, MD (Pacific Health Research Institute)	No disclosure on file
Giancarlo Comi, MD (University Vita-Salute)	Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Aspen Healthcare. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Rewind.
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.
Lon R. White, MD	No disclosure on file

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