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Do blood pressure drugs slow down dementia progression?

Could taking certain blood pressure drugs slow how quickly dementia gets worse? The authors of a new study suggest this may be the case, but we can’t be sure from these findings.

BMJ Group News

What do we know already?

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Recent research suggests that the number of people aged 65 and older with dementia in the UK was 670,000 in 2011, or between 6 and 7 in every 100 people in this age group.

At the moment, there are no medicines that can prevent dementia, or stop it once it starts. Most treatments focus on helping with symptoms, such as forgetfulness and confusion.

Researchers wanted to know whether medicines called centrally-acting ACE inhibitors (CACE-I) could help slow down how fast the disease gets worse. These medicines lower blood pressure, which has been linked to slower progression of dementia. They may also have an effect on the brain, which may make them more likely to have a role in dementia than other types of blood pressure medicines.

The study included 817 people with dementia. Some people were on CACE-I treatment and others were not. The participants took two tests designed to measure their memory, understanding, and ability to carry out simple tasks. They retook the tests six months later, and then the researchers measured whether there had been a change in their scores, and how quickly their scores had declined.

What does the new study say?

After six months there were small differences in how well people who took CACE-I did on the dementia tests, compared with those who didn’t take these medicines.

People in their first six months of treatment with CACE-I improved their scores slightly over the course of the study. But the average improvement was less than the minimum amount that is usually considered necessary to make a noticeable difference in people’s everyday lives.

People who didn’t take CACE-I, or who had been taking these drugs for longer, did worse on the tests after six months than they did at the start of the study. The rate of decline was slightly lower for people who took CACE-I. However, the difference between the groups could have been down to chance.

How reliable is the research?

This type of study observes people over a period of time, without controlling what treatments they take, and there’s a limit to how much we can learn from it.

Although 871 people were included in the study, only 361 people completed tests both at the start and end of the study, and only 85 of them were taking CACE-I. With small numbers like these, it becomes more likely that the results can be affected by chance.

What does this mean for me?

If you or someone you care for has dementia, it’s not likely that doctors will recommend blood pressure medicines as a treatment based on this study. These findings show there may be a link between taking CACE-I and scores on dementia tests, but we need more research to know whether taking CACE-I makes a difference to how quickly dementia gets worse.

Published on July 26, 2013

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