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A community cohort of 1270 non-demented 75+ years old persons was followed to evaluate the influence of blood pressure on incidence of dementia. Two hundred and eighteen dementia cases were detected during an average of three years of follow-up. Subjects with baseline systolic pressure ≥ 180 mm Hg had an age- and gender-adjusted relative risk (RR) of 1.6 (95% to persons with systolic pressure of 141-160 mm Hg. This association persisted, although not statistically significant, when education, vascular diseases, and antihypertensive drug use were entered in the model (RR = 1.4; 95% systolic pressure were not related to dementia incidence. However, individuals with a decrease of 5--19 mm Hg and ≥ 20 mm Hg in systolic pressure from baseline to follow-up had a RR of 1.8 (95% 2.6) and 2.5 (95% also found in subjects with diastolic pressure reduction. In conclusion, our findings support an association between high systolic pressure and increased risk of dementia, whereas blood pressure reduction may be secondary to the dementia process itself. [ABSTRACT FROM AUTHOR]

Objective: To examine whether antihypertensive medication use can affect the occurrence and progression of dementia. Subjects and Methods: In a community cohort of 1810 persons aged 75 years and older, 225 prevalent cases of dementia were detected. Among the 1301 persons without dementia, 224 incident cases of dementia were identified during an average period of 3 years. Among the 225 prevalent cases of dementia, 79 were suitable for the analysis of cognitive decline. Information on drug use was collected for the 2 weeks preceding the baseline interview. Results: Subjects taking antihypertensive medication (n=651, 83.9% of whom took diuretics) had a lower prevalence of dementia than those not taking antihypertensive medication (P<.001). Subjects without dementia who were taking antihypertensive medication at baseline (n=584) had a reduced incidence of dementia (adjusted relative risk, 0.7; 95% confidence interval, 0.6-1.0; P=.03). Furthermore, subjects taking diuretics (n=484) had an adjusted relative risk of 0.7 (95% confidence interval, 0.5-1.0; P=.02) for all dementia, and subjects taking diuretic monotherapy (n=345) had an adjusted relative risk of 0.6 (95% confidence interval, 0.4-0.9; P=.006). The use of other antihypertensive medication (calcium antagonists or β-blockers), however, was related to a reduced risk of Alzheimer disease (adjusted relative risk, 0.6; 95% confidence interval, 0.3-1.2) only in the subpopulation with a higher baseline blood pressure (n=458). Patients with dementia at baseline who were not taking diuretics had a 2-fold faster rate of decline in the score on the Mini-Mental State Examination than those taking diuretics. Conclusion: The use of diuretics may protect against dementia in elderly persons. [ABSTRACT FROM AUTHOR]

Reports on how patients with dementia generally have lower blood pressure than people without dementia. Details of the Kungsholmen Project, a longitudinal study of aging and dementia in all people in the Kungsholmen district of Stockholm, Sweden; Statistics.