P1‐125: Use of angiotensin receptor blockers is associated with decreased risk of dementia in older adults: Secondary analysis of the Ginkgo Evaluation of Memory Study

There is limited information on incidence of dementia among users of angiotensin-1 receptor blockers (ARB) or angiotensin-converting enzyme inhibitors (ACE-I). The objective of this study was to determine whether use of ARB or ACE-I is associated with reduced incidence of dementia and Alzheimer's disease (AD) in older adults with normal cognition or mild cognitive impairment (MCI) at baseline. Secondary longitudinal data analysis of the Ginkgo Evaluation of Memory Study (GEMS) in community-dwelling adults at least 75 years of age with normal cognition (n = 2587) or MCI (n = 482) at baseline. The main outcome of this study was incident dementia and AD over a median 6.1-year period using Cox proportional hazard models after adjusting for confounders including hypertension. 57.1% reported antihypertensive medication use at baseline of which 3.7% was ARB use and 16.7% ACE-I. There were 324 cases of dementia in participants with normal cognition and 199 cases in participants with MCI. ARB use was associated with a lower risk of incident dementia in participants with normal cognition and MCI compared with non-users of ARB. Hazard ratios (HR) and 95% Confidence Intervals (CI) for dementia in participants with normal cognition and MCI were 0.57 (0.41–0.78; p = .001) and 0.41 (0.25–0.67; p = 0.0003) respectively for ARBs.Results were similar for incident AD, 0.51 (0.33–0.78; p = 0.002) and 0.46 (0.26–0.80; p = 0.006). There was no significant difference in risk of incident dementia among ACE-I users in participants with normal cognition and MCI 0.79 (0.63–1.00; p = .052) and 0.41 (0.82–1.51; p = 0.50), respectively. ARB use was associated with reduced incidence of dementia and AD in participants with normal cognition or MCI at baseline.