Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Dementia, BP and Statins

In the past two days there has been news coverage of the benefits of statins and angiotensin receptor blockers (ARBs) in the prevention of dementia.

The first story details the results of an observational study of approximately six million people treated for high blood pressure between 2001 and 2006. This study found that people treated with ARBs were 40% less likely to develop dementia. Additionally, people who already had dementia were 45% less likely to worsen as measured by development of delirium, being admitted to a nursing home or dying prematurely.

The Alzheimer's Society has responded to this promising news by recommended that a "proper clinical trial is now needed to investigate" these potential benefits.

The second story details the results of a population based study published in Neurology. The study involved 1,674 Mexican Americans aged 60 and over who did not have dementia at the start of the study. Of this group, 27% took a lipid lowering therapy at some point during the study.

After correcting for several factors including education, smoking status and history of stroke or diabetes it was found that those who had used statins were about half as likely to develop dementia. (Hazard Ratio 0.52, 95% CI 0.34 - 0.80)

Again the Alzheimer's Society has responded cautiously stating that, "jury is still out on how effective they [statins] are" and that professional medical advice should be sought.

Action: Clinicians may be asked about these developments by patients. In both cases more research is required to ensure that these observed benefits are real and that any benefits are greater than the risks of treatment.

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