Effects of cardiovascular pharmacotherapies on incident dementia in patients with atrial fibrillation: A cohort study of all patients above 45 years diagnosed with AF in hospitals in Sweden

Research output: Contribution to journalArticle

Abstract

Background: Patients with atrial fibrillation (AF) have an increased dementia risk dementia. We aimed to study the effect of antihypertensive drugs on dementia in AF patients. Methods: Included patients were ≥45 years diagnosed with AF in Swedish National Patient Register (n = 160,251; 89,723 men and 70,528 women) and alive on January 1, 2007. We excluded patients with dementia before onset of AF. Cox regression was used (hazard ratios, HRs, and 99% confidence interval, CI) with adjustments for sex, age, socioeconomic factors and co-morbidities, using incident dementia diagnosis until December 31, 2015 as outcome. Cardiovascular pharmacotherapies were obtained from the Swedish Prescribed Drug Register. Results: Incident dementia occurred in 9532 patients (5.9%), 4669 men (5.2%) and 4863 women (6.9%). ARBs were associated with lower risk for all patients (HR 0.87, 99% CI 0.78–0.98), especially in the ages 65–84 years of age (HR 0.87, 99% CI 0.76–0.99). Loop-diuretics were associated with higher risk for all dementia among patients 65–84 years of age (HR 1.16, 99% CI 1.00–1.35), and in the sub-group of other causes of dementia than Alzheimer Disease (AD) and vascular dementia (VaD) (HR 1.14, 99% CI 1.00–1.30), but with a lower risk in the sub-group of AD and VaD (HR 0.81, 99% CI 0.68–0.95). Conclusion: ARBs were associated with a decreased incidence of dementia, and loop diuretics with a higher risk in general but lower risk in the AD and VaD sub-group. ARBs could have specific advantages in prevention of dementia, but the results need confirmation in further studies.

Details

Authors
Organisations
External organisations
  • Karolinska Institutet
  • Icahn School of Medicine at Mount Sinai
  • Shimane University
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems

Keywords

  • Antihypertensive drugs, Atrial fibrillation, Dementia, Gender, Hypertension
Original languageEnglish
Pages (from-to)55-60
JournalInternational Journal of Cardiology
Volume297
Early online date2019
Publication statusPublished - 2019
Publication categoryResearch
Peer-reviewedYes