Certain combos of statins, antihypertensives lower dementia risk

Novel combinations of existing cholesterol meds and antihypertensives may reduce older patients’ risk of developing Alzheimer’s disease and other dementias, according to research published March 10 in PLOS One.

For their work, lead author Julie Zissimopoulos and colleagues at the University of Southern California studied the medical and pharmacy claims of nearly 700,000 Medicare beneficiaries, all aged 67 or up. The authors said there’s been a heightened focus on dementia prevention and risk reduction in recent years, prompting the need for better solutions that don’t yet exist. More than a century after scientists identified the first-ever case of what became known as Alzheimer’s, we still lack a proven treatment for the disease.

“We don’t currently have drugs that are proven to treat dementia, but even small delays in onset can dramatically reduce the burden on patients, caregivers and the health system as a whole,” Zissimopoulos said in a release.

Zissimopoulos et al. said that around 25% of older adults use both antihypertensives and statins together to manage high blood pressure and high cholesterol, so the researchers looked into those drug-drug interactions. Their study population, initially dementia-free, was enrolled in Medicare between 2007 and 2014, and all patients had used both an antihypertensive and a statin for two years prior to the study’s baseline.

The authors found that two statins in particular—pravastatin and rosuvastatin—reduced patients’ dementia risk when taken alongside either an ACE inhibitor or angiotensin II receptor blocker (ARB). Other combinations weren’t as effective.

The greatest risk reduction was found with a regimen of either pravastatin or rosuvastatin and ARBs, and that reduction was more apparent in men than in women. Compared to people using other drug combos, a combination of pravastatin and an ARB resulted in 21% lower odds of a dementia diagnosis.

Zissimopoulos and her colleagues, who include paper co-author Douglas Barthold of the University of Washington, said their findings need to be replicated in other studies before they can move forward. If the statin/antihypertensive combinations are continuously found to reduce Alzheimer’s and dementia risk, the team said their work could have implications for future guidelines and recommendations.

“We know that managing hyperlipidemia and hypertension is important, and this study tells us there might be certain combinations of drugs that have additional benefits for Alzheimer’s and other dementias beyond the management of those targeted conditions,” Barthold said.