Angiotensin II–Stimulating Antihypertensive Medications and Dementia-Related Neuropathology

Are antihypertensive medications that stimulate vs inhibit angiotensin II type 2 or 4 receptors associated with lower risk for neuropathology burden beyond blood pressure control?In this cohort study with 756 decedents, cumulative angiotensin II–stimulating exposure was associated with lower risk for some types of neuropathology relative to angiotensin II–inhibiting exposure. Long-term angiotensin II–stimulating exposure (≥15 years) was associated with a 24% lower risk for arteriolosclerosis.This study suggests that, relative to angiotensin II–inhibiting antihypertensive exposure, angiotensin II–stimulating antihypertensive medications were associated with lower risk of certain dementia-related neuropathologies.

Corresponding Author: Shelly L. Gray, PharmD, MS, Department of Pharmacy, School of Pharmacy, University of Washington, 1959 NE Pacific St, Box 357630, Seattle, WA 98102 (slgray@uw.edu).

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