| Non-adherence to antihypertensive medication and impaired cognition: which comes first? | |
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MedLine Citation:
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PMID: 20840680 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Antihypertensive medications are important in the prevention of serious consequences of hypertension, such as stroke and heart failure. Up to one-third of elderly hypertensive patients, however, do not adhere to their medication. Adherence to medication decreases with increasing age, and with decreasing cognitive ability, thus elderly, cognitively-impaired patients have poorer control of blood pressure. Good control of blood pressure is associated with decreased prevalence of dementia and Alzheimer's disease. This study assessed the evidence that antihypertensive medications have effects on the prevalence or severity of mild cognitive impairment, dementia or Alzheimer's disease. METHODS: The ISI Web of Knowledge database was searched; including replicates, the nine searches identified 14400 publications since 1952, of which 9.9% had been published in 2009. This review considers the 18 studies meeting the set criteria published in 2009 or later. KEY FINDINGS: Not all antihypertensive medications are equivalent in their positive cognitive effects, with brain-penetrating angiotensin-converting-enzyme inhibitors and possibly angiotensin receptor antagonists being the most effective. CONCLUSIONS: Based on evidence of blood-pressure control and cost, UK National Institute for Health and Clinical Excellence guidelines recommend calcium-channel blockers or thiazide-type diuretics for the treatment of hypertension in patients over 55 years. These guidelines take no account of the potential cognitive effects of the antihypertensive therapies, consideration of which might lead to a review. There may be benefit in stressing that adherence to antihypertensive medication not only decreases the risk of cardiovascular disease and death, but may also decrease the risk or severity of mild cognitive impairment, dementia and Alzheimer's disease. |
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Authors:
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Paul R Gard |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: The International journal of pharmacy practice Volume: 18 ISSN: 0961-7671 ISO Abbreviation: Int J Pharm Pract Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-15 Completed Date: 2010-10-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9204243 Medline TA: Int J Pharm Pract Country: England |
Other Details:
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Languages: eng Pagination: 252-9 Citation Subset: IM |
Copyright Information:
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© 2010 The Author. IJPP © 2010 Royal Pharmaceutical Society of Great Britain. |
Affiliation:
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School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK. p.r.gard@brighton.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Antihypertensive Agents / therapeutic use* Cognition Disorders / drug therapy* Guidelines as Topic Humans Hypertension / drug therapy* Medication Adherence* Middle Aged |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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