Abstract:
OBJECTIVE: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. METHODS: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. RESULTS: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 = 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 = 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 = 0.182). CONCLUSIONS: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.
journal_name
Int J Clin Practjournal_title
International journal of clinical practiceauthors
Ye R,Hu Y,Yao A,Yang Y,Shi Y,Jiang Y,Zhang Jdoi
10.1111/ijcp.12626subject
Has Abstractpub_date
2015-06-01 00:00:00pages
674-81issue
6eissn
1368-5031issn
1742-1241journal_volume
69pub_type
杂志文章,meta分析abstract::The phenomenon of spontaneous remission is one of the less well known aspects of the leukaemias. Spontaneous remission has been reported in both acute and chronic leukaemia. The mechanism is unclear but may involve immune modulation related to an intercurrent infection or transfusion of blood products. We present a ra...
journal_title:International journal of clinical practice
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abstract:BACKGROUND:In clinical practice, hyponatraemia was frequently found in patients with hydrocephalus. We conducted this study to determine the prevalence and risk factors for hyponatraemia in patients with normal pressure hydrocephalus (NPH). METHODS:We retrospectively reviewed all patients with NPH who were admitted to...
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abstract::Calcium dobesilate (Doxium) is used in the treatment of diabetic retinopathy. Clinical studies show a slowdown of the progression of the disease after long-term oral treatment. The main action of the drug is related to a reduction of microvascular permeability as measured by different parameters and methods (vitreous ...
journal_title:International journal of clinical practice
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abstract::Indiplon is a novel non-benzodiazepine sedative-hypnotic that modulates the GABAA receptor complex. It appears to be more selective for the alpha1-receptor subunit, associated with sedation, than other hypnotics. Two different formulations of indiplon have been developed: an immediate release (IR) version targeting sl...
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abstract::Although uric acid (UA) is considered as an antioxidant, the relationship between serum UA levels and cardiovascular diseases is not clear yet. Higher brachial artery resting diameter (BD), impaired brachial artery flow-mediated dilatation (FMD), increased carotid intima-media thickness (IMT), decreased aortic distens...
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journal_title:International journal of clinical practice
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journal_title:International journal of clinical practice
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journal_title:International journal of clinical practice
pub_type: 杂志文章,多中心研究
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journal_title:International journal of clinical practice
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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journal_title:International journal of clinical practice
pub_type: 临床试验,杂志文章,多中心研究
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journal_title:International journal of clinical practice
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更新日期:2001-05-01 00:00:00
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