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Investigation of antihypertensive class, dementia, and cognitive decline: A meta-analysis
Peters R, Yasar S, Anderson CS, Andrews S, Antikainen R, Arima H, Beckett N, Beer JC et al.. Neurology, 2019-12-11
Topic: Risk, prevention and care in population studies
Plain-language summary
Objective High blood pressure is one of the main modifiable risk factors for dementia. However, there is conflicting evidence regarding the best antihypertensive class for optimizing cognition. Our objective was to determine whether any particular antihypertensive class was associated with a reduced risk of cognitive decline or dementia using comprehensive meta-analysis including reanalysis of original participant data. Methods To identify suitable studies, MEDLINE, Embase, and PsycINFO and preexisting study consortia were searched from inception to December 2017. Authors of prospective longitudinal human studies or trials of antihypertensives were contacted for data sharing and collaboration. Outcome measures were incident dementia or incident cognitive decline (classified using the reliable change index method). Data were separated into mid and late-life (>65 years) and each antihypertensive class was compared to no treatment and to treatment with other antihypertensives. Meta-analysis was used to synthesize data. Results Over 50,000 participants from 27 studies were included. Among those aged >65 years, with the exception of diuretics, we found no relationship by class with incident cognitive decline or dementia. Diuretic use was suggestive of benefit in some analyses but results were not consistent across follow-up time, comparator group, and outcome. Limited data precluded meaningful analyses in those ≤65 years of age. Conclusion Our findings, drawn from the current evidence base, support clinical freedom in the selection of antihypertensive regimens to achieve blood pressure goals. Clinical trials registration The review was registered with the international prospective register of systematic reviews (PROSPERO), registration number CRD42016045454.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Peters, R., Yasar, S., Anderson, C. S., Andrews, S., Antikainen, R., Arima, H., et al. (2020). Investigation of antihypertensive class, dementia, and cognitive decline: A meta-analysis. Neurology. https://doi.org/10.1212/wnl.0000000000008732
Vancouver
Peters R, Yasar S, Anderson CS, Andrews S, Antikainen R, Arima H, et al. Investigation of antihypertensive class, dementia, and cognitive decline: A meta-analysis. Neurology. 2020. doi:10.1212/wnl.0000000000008732. PMID: 31827004.
BibTeX
@article{peters2020-31827004,
author = {Peters, R. and Yasar, S. and Anderson, C. S. and Andrews, S. and Antikainen, R. and Arima, H. and Beckett, N. and Beer, J. C. and others},
title = {{Investigation of antihypertensive class, dementia, and cognitive decline: A meta-analysis}},
journal = {Neurology},
year = {2020},
doi = {10.1212/wnl.0000000000008732},
pmid = {31827004},
url = {https://doi.org/10.1212/wnl.0000000000008732}
}
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Key findings
- Our objective was to determine whether any particular antihypertensive class was associated with a reduced risk of cognitive decline or dementia using comprehensive meta-analysis including reanalysis of original participant data.
- Data were separated into mid and late-life (>65 years) and each antihypertensive class was compared to no treatment and to treatment with other antihypertensives.
- Results Over 50,000 participants from 27 studies were included.
- Among those aged >65 years, with the exception of diuretics, we found no relationship by class with incident cognitive decline or dementia.
- Diuretic use was suggestive of benefit in some analyses but results were not consistent across follow-up time, comparator group, and outcome.
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Study details
- Study designmeta-analysis
- Participants50,000
- Evidence strengthHigh
How this study scored 81/100
Published in a leading specialty journal, and it is a meta-analysis pooling many studies. Scored zero for effect reported because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 47 of the 58 points we could judge it on, which is 81 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 12 / 12 | A meta-analysis pooling many studies |
| 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 | 2 / 5 | 2020 — within 10 year(s) of the newest study here |
| Sample size | 4 / 4 | 50,000 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 | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 31827004) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 47 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 47 of the 58 points we could judge it on is 81 out of 100. |
| Total | 81 / 100 | — |
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