[P1–618]: LOWER DEMENTIA RISK WITH DIFFERENT CLASSES OF ANTIHYPERTENSIVE MEDICATION IN OLDER PATIENTS

Use of antihypertensive medication (AHM) is potentially associated with a reduced risk of dementia. Both calcium channel blockers (CCBs) and angiotensin-2 receptor blockers (ARBs) are suggested to have a more pronounced protective effect. We aimed to study the association between different classes of AHM and dementia in older people. A subgroup of community-dwelling older people using AHM included in the ‘Prevention of Dementia by Intensive Vascular Care’ (preDIVA) randomised controlled trial was studied. Incident dementia rates in participants with different AHM classes (mono- and combination therapy) were compared to dementia rates in participants with any other AHM. At baseline, 1951 participants (55.3%) used AHM (mean age, 74.4 year [SD 2.5]; mean systolic blood pressure, 156.4 mmHg [SD 21.5]). 986 participants (50.5%) used beta-blockers, 798 diuretics (40.9%), 623 angiotensin converting enzyme inhibitors (31.9%), 522 CCBs (26.8%), and 402 ARBs (20.6%). After 6.7 years (interquartile range 6.0–7.3) of follow-up, 136 participants (7.0%) developed dementia. Both use of CCBs (hazard ratio [HR] 0.56, 95% confidence interval [95% CI] 0.36–0.87) and ARBs (HR 0.60, 95% CI 0.37–0.98) were independently associated with a decreased risk of dementia. The association of CCBs with dementia was most apparent in participants without a history of cardiovascular disease (HR 0.38, 95% CI 0.18–0.81) and with uncontrolled hypertension (HR 0.26, 95% CI 0.11–0.61). Systolic blood pressure was not significantly lower in participants using CCBs or ARBs. Both use of CCBs and ARBs are independently associated with a decreased risk of dementia in older people.