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Antihypertensive classes, cognitive decline and incidence of dementia: a network meta-analysis
Levi Marpillat N, Macquin-Mavier I, Tropeano AI, Bachoud-Levi AC, Maison P.. Journal of hypertension, 2013-06-01
Topic: Risk, prevention and care in population studies
Objectives Prevention of cognitive decline and dementia with blood pressure lowering treatments has shown inconsistent results. We compared the effects of different classes of antihypertensive drugs on the incidence of dementia, and on cognitive function. Methods We conducted a systematic review and included 19 randomized trials (18 515 individuals) and 11 studies (831 674 individuals) analysing the effects of antihypertensive treatment on cognition and on the incidence of dementia, respectively, in hypertensive patients without prior cerebrovascular disorders. Network meta-analysis was used for the comparison of antihypertensive classes. Results Antihypertensive treatment, regardless of the drug class, had benefits on overall cognition [effect size 0.05, 95% confidence interval (CI) 0.02-0.07] and all cognitive functions except language. Antihypertensive treatment reduced the risk of all-cause dementia by 9%, with reference to the control group (hazard ratio 0.91, 95% CI 0.89-0.94), when randomized trials and observationnal studies were combined (n = 15). Result was not significant with randomized trials alone (n = 4). Angiotensin II receptor blockers (ARBs) had larger benefits than placebo on overall cognition (adjusted effect size 0.60 ± 0.18, P = 0.02). ARBs were more effective than β-blockers (0.67 ± 0.18, P = 0.01), diuretics (0.54 ± 0.19, P = 0.04) and angiotensin-converting enzyme inhibitors (0.47 ± 0.17, P = 0.04) in rank. The mean change in blood pressure did not differ significantly between the different antihypertensive drug classes. Conclusion Our results support the notion that antihypertensive treatment has beneficial effects on cognitive decline and prevention of dementia, and indicate that these effects may differ between drug classes with ARBs possibly being the most effective.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Levi Marpillat, N., Macquin-Mavier, I., Tropeano, A. I., Bachoud-Levi, A. C., & Maison, P. (2013). Antihypertensive classes, cognitive decline and incidence of dementia: a network meta-analysis. Journal of hypertension. https://doi.org/10.1097/hjh.0b013e3283603f53
Vancouver
Levi Marpillat N, Macquin-Mavier I, Tropeano AI, Bachoud-Levi AC, Maison P. Antihypertensive classes, cognitive decline and incidence of dementia: a network meta-analysis. Journal of hypertension. 2013. doi:10.1097/hjh.0b013e3283603f53. PMID: 23552124.
BibTeX
@article{levimarpillat2013-23552124,
author = {Levi Marpillat, N. and Macquin-Mavier, I. and Tropeano, A. I. and Bachoud-Levi, A. C. and Maison, P.},
title = {{Antihypertensive classes, cognitive decline and incidence of dementia: a network meta-analysis}},
journal = {Journal of hypertension},
year = {2013},
doi = {10.1097/hjh.0b013e3283603f53},
pmid = {23552124},
url = {https://doi.org/10.1097/hjh.0b013e3283603f53}
}
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Key findings
- Objectives Prevention of cognitive decline and dementia with blood pressure lowering treatments has shown inconsistent results.
- Results Antihypertensive treatment, regardless of the drug class, had benefits on overall cognition [effect size 0.05, 95% confidence interval (CI) 0.02-0.07] and all cognitive functions except language.
- Result was not significant with randomized trials alone (n = 4).
- Angiotensin II receptor blockers (ARBs) had larger benefits than placebo on overall cognition (adjusted effect size 0.60 ± 0.18, P = 0.02).
- The mean change in blood pressure did not differ significantly between the different antihypertensive drug classes.
Why it matters
When randomized trials and observational studies were combined, antihypertensive treatment reduced the risk of all-cause dementia by 9%, but this result was not significant when randomized trials alone were analyzed. Angiotensin II receptor blockers showed larger benefits than placebo on overall cognition, though the review notes inconsistent results in this field.
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Study details
- Study designsystematic review
- Participants15
- Evidence strengthHigh
How this study scored 66/100
Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of hypertension) |
| Journal's citation record | 2 / 4 | Journal of Hypertension: journal h-index 236 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A systematic review of all the studies on the question |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2013 — within 20 year(s) of the newest study here |
| Sample size | 1 / 4 | 15 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | A review of other studies — randomization is not credited here |
| Times cited | 5 / 7 | Cited 254 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 16.9 citations a year over 15 year(s) since 2013 |
| Impact for its field and year | 4 / 6 | Cited 15.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 13 other studies in this library |
| Still being cited | 2 / 4 | Cited 33 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Patrick Maison: h-index 37 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Inserm: institution h-index 1,988 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 23552124) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 66 / 100 | — |
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