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Care of the older person
Antihypertensive medications may reduce the risk of dementia in older African–Americans with hypertension
  1. Tomas Welsh1,2,3,
  2. Jane Masoli4,5
  1. 1 Research Institute for the Care of Older People, Bath, UK
  2. 2 Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
  3. 3 School of Clinical Science, University of Bristol, Bristol, UK
  4. 4 University of Exeter Medical School, Exeter, UK
  5. 5 Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
  1. Correspondence to Dr Tomas Welsh, Research Institute for the Care of Older People (RICE), Royal United Hospital, Bath BA1 3NG, UK; tomas.welsh{at}nhs.net

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Commentary on: Murray MD, Hendrie HC, Lane KA, et al. Antihypertensive Medication and Dementia Risk in Older Adult African Americans with Hypertension: A Prospective Cohort Study. J Gen Intern Med. 2018 Apr;33:455–462.

Implications for practice and research

  • Treatment for hypertension to target blood pressure in community-dwelling African–Americans aged over 65 was associated with a reduced incidence of all-cause dementia.

  • This study provides further suggestion that lower blood pressure in late middle-age is associated with a reduced risk of developing dementia in later life.

  • There is no indication on the basis of these findings to modify current guidance on blood pressure management in older people.

  • Interpretation of this study’s findings is hampered by methodological issues. Future research examining the association between antihypertensive use and incident dementia should adopt an approach which avoids these complexities. 

Context 

High blood pressure is very common amongst older adults,1 with blood pressure increasing into middle age and then falling towards the end of …

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