Calcium channel blockers represent an important protective factor against the risk of dementia. Therefore, hypertensive elderly patients can benefit by reducing their blood pressure as well as reducing the risk of dementia.
Elderly people with hypertension are usually treated with calcium channel blockers (CCBs). These drugs have the potential to reduce their blood pressure by acting on and expanding the diameter of the arteries after interfering with the calcium concentration. The dysfunction of calcium concentration may be an important trigger of neuronal deficits, contributing to the accumulation of amyloid-beta peptide. The vicious cycle between calcium and amyloid-beta peptide has been associated with dementias such as Alzheimer’s disease (AD) and vascular dementia. However, CCBs seem to have a neuroprotective effect by reducing the accumulation of amyloid-beta peptide and consequently improving the cerebrovascular perfusion and relaxation of the cerebral vasculature.
A study conducted by researchers from Taiwan analyzed the potential impact of CCBs as protective factors against the risk of dementia in 4,004 elderly individuals receiving or not receiving CCBs. The individuals were classified according to the type of antihypertensive drugs they were taking (CCB, angiotensin receptor blockers, angiotensin-converting enzyme inhibitors, diuretics, alpha-blockers, and beta-blockers). The authors analyzed the treatment duration and defined daily dose (DDD), cumulative exposure to antihypertensive drugs, dose per day, number of DDDs and the exposure-risk period. Hypertensive individuals with similar characteristics were selected for comparison. Individuals using two types of antihypertensive drugs along with CCBs were excluded. CCBs exposure, patients’ demographics, the year of hypertension diagnosis, and baseline comorbidities were controlled for. The diagnosis of dementia was also analyzed. Both groups experienced similar complications during the follow-up.
The results showed that CCBs treatment not only reduced blood pressure, but also the incidence of dementia after four years of follow-up. This effect may be exerted through the inhibition of calcium channels and reduction of amyloid-beta peptide induced by CCBs. The fact that some individuals were excluded if they used CCB along with two other drugs was an important factor in order to minimize the effect of other drugs and to isolate the effects related to the CCBs use. However, it is not possible to generalize the results for other patients under a combination therapy. Moreover, disease severity, drug dosage, education programs, lifestyle and genetic factors were not controlled for. In this way, the findings represent an association between CCBs and risk of dementia, but not necessarily a causal relationship.
The results concerning the neuroprotective effect of CCBs in the risk of dementia in hypertensive elderly patients were consistent and suggest a significant pharmacological strategy against the risk and the potential development of dementia.
Written By: Vagner Raso