Cardiovascular drugs may reduce dementia risk

Common cardiovascular drugs are linked to a lower risk of dementia in older age, according to a new study from Karolinska Institutet published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association.

Cardiovascular disease and dementia are major public health challenges that cause a significant burden on both healthcare and society. A new study from Karolinska Institutet in Sweden shows that long-term use of common cardiovascular drugs is associated with lower risk of dementia later in life.

“We can see a clear link between long-term use – five years or more – of these drugs and reduced risk of dementia in older age,” says Mozhu Ding, assistant professor at the Institute of Environmental Medicine, Karolinska Institutet, and one of the lead authors of the paper.

The researchers used Swedish national registers. Around 88,000 people over the age of 70 who were diagnosed with dementia between 2011 and 2016 were included in the study, as well as 880,000 controls. Information on cardiovascular medicines was obtained from the Swedish Prescribed Drug Register.

The results show that long-term use of antihypertensive drugs, cholesterol-lowering drugs, diuretics and blood-thinning drugs is associated with between 4 and 25 percent lower risk of dementia. Combinations of the drugs had stronger protective effects than if they were used alone.

“Previous studies have focused on individual drugs and specific patient groups but in this study, we take a broader approach,” says Alexandra Wennberg, affiliated researcher at the Institute of Environmental Medicine and the other lead author of the paper.

The researchers also found that, on the contrary, the use of antiplatelet drugs may be linked to a higher risk of dementia. Antiplatelet drugs are medicines used to prevent strokes and stop platelets from clumping together. One possible explanation is that these drugs increase the risk of microbleeds in the brain, which are associated with cognitive decline.

The study is an important piece of the puzzle for finding new treatments for dementia, according to the researchers.

“We currently have no cure for dementia, so it’s important to find preventive measures,” says Alexandra Wennberg.

The researchers stress the importance of further studies, especially randomised controlled clinical trials, to better understand the mechanisms behind the findings. Among other things, they will continue to study how diet and lifestyle, in addition to drug treatment for cardiovascular disease, affect the risk of developing dementia.

The research was carried out by Karolinska Institutet and Lund University with research funding from Karolinska Institutet. Alexandra Wennberg has received funding from Janssen Phamaceutica NV for an unrelated project. No other potential conflicts of interest are disclosed.

Publication: "Use of common cardiovascular disease drugs and risk of dementia: A case-control study in Swedish national register data", Mozhu Ding, Alexandra M. Wennberg, Gunnar Engström, Karin Modig, Alzheimer's & Dementia: The Journal of the Alzheimer's Association, online 18 November 2024, doi: 10.1002/alz.14389.