Renin-angiotensin system-targeting antihypertensive drugs and risk of vascular cognitive impairment: A meta-analysis

Neuroscience Letters
Shan ZhuangCheng-ming Xing

Abstract

To evaluate the effects of renin-angiotensin system (RAS)-targeting antihypertensive drugs and its classes on the incidence of vascular cognitive impairment (VCI). Pubmed, Embase, and Cochrane Library database of selected articles, and previous systematic reviews through May 2015 were searched. Studies that evaluated the association between use of RAS-targeting drugs and VCI were included. Relative risks (RRs) with 95% confidence intervals (CIs) were pooled using fixed effects models or random effects models. In all studies as a whole, the use of RAS-targeting drugs was significantly associated with a reduced risk of VCI (RR, 0.87; 95% CI, 0.75-0.98) and vascular dementia (VD) (RR, 0.78; 95% CI, 0.64-0.93), compared no use of RAS-targeting drugs. Subgroup analysis showed that subjects with Angiotensin-Converting Enzyme Inhibitors (ACEI) use significantly associated with a reduced incidence of VCI (RR, 0.81; 95% CI 0.70-0.91) and VD (RR, 0.75; 95% CI, 0.57-0.93); however, subjects with Angiotensin Receptor Blockers (ARB) use had not this effect on VCI (RR, 0.94; 95% CI 0.76-1.13) or VD (RR, 0.94; 95% CI, 0.45-1.44). In an analysis of subgroups, case-control studies found that the use of RAS-targeting drugs could effectively decr...Continue Reading

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