Impact of renin–angiotensin system‐targeting antihypertensive drugs on treatment of Alzheimer's disease: a meta‐analysis. Issue 6 (27th February 2015)

• Record Type: Journal Article
• Authors: Ye, R.; Hu, Y.; Yao, A.; Yang, Y.; Shi, Y.; Jiang, Y.; Zhang, J.
• Is Part Of: International journal of clinical practice. Volume 69:Issue 6(2015)
• Page Start: 674
• Page End: 681
• Publication Date: 2015-02-27
• Subjects: Clinical medicine -- Periodicals; Medicine -- Periodicals; 610.5
• DOI: 10.1111/ijcp.12626
• Languages: English
• ISSNs: 1368-5031

Abstract

<abstract abstract-type="main" id="ijcp12626-abs-0001"> <title>Summary</title> <sec id="ijcp12626-sec-0001" sec-type="section"> <title>Objective</title> <p>The impacts of renin–angiotensin system (RAS)‐targeting antihypertensive drugs on Alzheimer's disease (AD) remain controversial. We performed this meta‐analysis to evaluate the precise value of RAS‐targeting antihypertensive drugs in terms of attenuating incidence of AD and slowing down cognitive decline in patients with AD.</p> </sec> <sec id="ijcp12626-sec-0002" sec-type="section"> <title>Methods</title> <p>A systematic literature search was conducted using PubMed, Embase, ScienceDirect and CBM (China Biology Medicine Disc) before September 2014. Studies analysing incidence of AD and cognitive changes in AD patients with RAS‐targeting antihypertensive drugs were identified. The principal outcome measures were hazard ratios (HRs) for incidence of AD and standardised mean difference (SMD) for cognitive changes in AD patients. Pooled data were calculated using fixed or random effects models according to the heterogeneity.</p> </sec> <sec id="ijcp12626-sec-0003" sec-type="section"> <title>Results</title> <p>In total, 12 studies involving 896, 410 participants met our inclusion criteria. RAS‐targeting antihypertensive drugs were significantly associated with a reduced incidence rate of AD (HR 0.81, 95% CI 0.72–0.92, p<italic> </italic>=<italic> </italic>0.001). In subgroup analysis, both angiotensin renin blockers and angiotensin converting enzyme inhibitors were shown to effectively decrease the incidence rate of AD. In the analysis of cognitive changes, a slower rate of cognitive decline was observed in AD patients with RAS‐targeting antihypertensive drug (SMD 0.30, 95% CI 0.09–0.50, p<italic> </italic>=<italic> </italic>0.004), when randomised trials and observational trials were combined. However, analysis of randomised trials alone did not show the same result (SMD 0.20, 95% CI −0.10 to 0.50, p<italic> </italic>=<italic> </italic>0.182).</p> </sec> <sec id="ijcp12626-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Renin–angiotensin system‐targeting antihypertensive drugs may be a potential treatment for reducing the incidence and progression of AD. Further studies on RAS‐targeting antihypertensive drugs, especially large randomised clinical trials, should be conducted in the future.</p> </sec> </abstract>