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dc.rights.licenseopenen_US
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorTULLY, Phillip J.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorHELMER, Catherine
dc.contributor.authorPETERS, R.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorTZOURIO, Christophe
dc.date.accessioned2020-07-16T09:54:25Z
dc.date.available2020-07-16T09:54:25Z
dc.date.issued2019-02
dc.identifier.issn1538-9375 (Electronic) 1525-8610 (Linking)en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/10487
dc.description.abstractEnOBJECTIVES: The objective was to test the hypothesis that antihypertensive drugs have a differential effect on cognition in carriers and noncarriers of the apolipoprotein epsilon4 (APOE4) polymorphism. DESIGN: Prospective population-based cohort, France. SETTING AND PARTICIPANTS: A total of 3359 persons using antihypertensive drugs (median age 74 years, 62% women) were serially assessed up to 10 years follow-up. MEASURES: Exposure to antihypertensive drug use was established in the first 2 years. Cognitive function was assessed at baseline, 2, 4, 7, and 10 years with a validated test battery covering global cognition, verbal fluency, immediate visual recognition memory, processing speed, and executive function. Clinically significant change in cognitive function was determined using reliable change indices represented as z scores and analyzed with linear mixed-models. RESULTS: From 3359 persons exposed to antihypertensive drugs, 653 were APOE4 carriers (5.1% homozygous, 94.9% heterozygous) and median follow-up was 5.2 years (interquartile range 3.7-8.0). In APOE4 carriers, improved general cognitive function over time was associated with exposure to angiotensin converting enzyme inhibitors [beta = .14; 95% confidence interval (CI) .06-.23, P = .001] and angiotensin receptor blockers (beta = .11; 95% CI .02-.21, P = .019). Improved verbal fluency was associated with angiotensin converting enzyme inhibitors (beta = .11; 95% CI .03-.20, P = .012). CONCLUSIONS: Renin-angiotensin-system blockade was associated with improved general cognitive function in APOE4 carriers. Findings did not support renin-angiotensin-system drugs' lipophilicity or ability to cross the blood-brain barrier as potential mechanisms. The findings have implications for selecting the optimal antihypertensive drug in older populations at risk of cognitive decline and dementia.
dc.language.isoENen_US
dc.subject.enHEALTHY
dc.subject.enLEHA
dc.subject.enFR
dc.subject.en3C
dc.title.enExploiting Drug-Apolipoprotein E Gene Interactions in Hypertension to Preserve Cognitive Function: The 3-City Cohort Study
dc.title.alternativeJ Am Med Dir Assocen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1016/j.jamda.2018.08.002en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed30292766en_US
bordeaux.journalJournal of the American Medical Directors Associationen_US
bordeaux.page188-194 e4en_US
bordeaux.volume20en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - U1219en_US
bordeaux.issue2en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.teamLEHA_BPH
bordeaux.teamHEALTHY_BPH
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-03163410
hal.version1
hal.date.transferred2021-03-09T10:30:11Z
hal.exporttrue
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