@article{fdi:010089017,
  title = {{U}se of antihypertensives, blood pressure, and estimated risk of dementia in late life : an individual participant data meta-analysis},
  author = {{L}ennon, {M}.{J}. and {L}am, {B}.{C}.{P}. and {L}ipnicki, {D}.{M}. and {C}rawford, {J}.{D}. and {P}eters, {R}. and {S}chutte, {A}.{E}. and {B}rodaty, {H}. and {T}halamuthu, {A}. and {R}ydberg-{S}terner, {T}. and {N}ajar, {J}. and {S}koog, {I}. and {R}iedel-{H}eller, {S}.{G}. and {R}{\¨o}hr, {S}. and {P}abst, {A}. and {L}obo, {A}. and {D}e-{L}a-{C}ámara, {C}. and {L}obo, {E}. and {B}ello, {T}; and {G}ureje, {O}. and {O}jagbemi, {A}. and {L}ipton, {R}.{B}. and {K}atz, {M}.{J}. and {D}erby, {C}.{A}. and {K}im, {K}.{W}. and {H}an, {J}.{W}. and {O}h, {D}.{J}. and {R}olandi, {E}. and {D}avin, {A}. and {R}ossi, {M}. and {S}carmeas, {N}. and {Y}annakoulia, {M}. and {D}ardiotis, {T}. and {H}endrie, {H}.{C}. and {G}ao, {S}. and {C}arri{\`e}re, {I}. and {R}itchie, {K}. and {A}nstey, {K}.{J}. and {C}herbuin, {N}. and {X}iao, {S}. and {Y}ue, {L}. and {L}i, {W}. and {G}uerchet, {M}a{\¨e}lenn and {P}reux, {P}.{M}. and {A}boyans, {V}. and {H}aan, {M}.{N}. and {A}iello, {A}.{E}. and {N}g, {T}.{P}. and {N}yunt, {M}.{S}.{Z}. and {G}ao, {Q}. and {S}cazufca, {M}. and {S}achdev, {P}.{S}.{S}.},
  editor = {},
  language = {{ENG}},
  abstract = {{I}mportance : {T}he utility of antihypertensives and ideal blood pressure ({BP}) for dementia prevention in late life remains unclear and highly contested. {O}bjectives : {T}o assess the associations of hypertension history, antihypertensive use, and baseline measured {BP} in late life (age >60 years) with dementia and the moderating factors of age, sex, and racial group. {D}ata source and study selection : {L}ongitudinal, population-based studies of aging participating in the {C}ohort {S}tudies of {M}emory in an {I}nternational {C}onsortium ({COSMIC}) group were included. {P}articipants were individuals without dementia at baseline aged 60 to 110 years and were based in 15 different countries ({US}, {B}razil, {A}ustralia, {C}hina, {K}orea, {S}ingapore, {C}entral {A}frican {R}epublic, {R}epublic of {C}ongo, {N}igeria, {G}ermany, {S}pain, {I}taly, {F}rance, {S}weden, and {G}reece). {D}ata extraction and synthesis : {P}articipants were grouped in 3 categories based on previous diagnosis of hypertension and baseline antihypertensive use: healthy controls, treated hypertension, and untreated hypertension. {B}aseline systolic {BP} ({SBP}) and diastolic {BP} ({DBP}) were treated as continuous variables. {R}eporting followed the {P}referred {R}eporting {I}tems for {S}ystematic {R}eview and {M}eta-{A}nalyses of {I}ndividual {P}articipant {D}ata reporting guidelines. {M}ain outcomes and measures : {T}he key outcome was all-cause dementia. {M}ixed-effects {C}ox proportional hazards models were used to assess the associations between the exposures and the key outcome variable. {T}he association between dementia and baseline {BP} was modeled using nonlinear natural splines. {T}he main analysis was a partially adjusted {C}ox proportional hazards model controlling for age, age squared, sex, education, racial group, and a random effect for study. {S}ensitivity analyses included a fully adjusted analysis, a restricted analysis of those individuals with more than 5 years of follow-up data, and models examining the moderating factors of age, sex, and racial group. {R}esults : {T}he analysis included 17 studies with 34 519 community dwelling older adults (20 160 [58.4%] female) with a mean ({SD}) age of 72.5 (7.5) years and a mean ({SD}) follow-up of 4.3 (4.3) years. {I}n the main, partially adjusted analysis including 14 studies, individuals with untreated hypertension had a 42% increased risk of dementia compared with healthy controls (hazard ratio [{HR}], 1.42; 95% {CI} 1.15-1.76; {P} =.001) and 26% increased risk compared with individuals with treated hypertension ({HR}, 1.26; 95% {CI}, 1.03-1.53; {P} =.02). {I}ndividuals with treated hypertension had no significant increased dementia risk compared with healthy controls ({HR}, 1.13; 95% {CI}, 0.99-1.28; {P} =.07). {T}he association of antihypertensive use or hypertension status with dementia did not vary with baseline {BP}. {T}here was no significant association of baseline {SBP} or {DBP} with dementia risk in any of the analyses. {T}here were no significant interactions with age, sex, or racial group for any of the analyses. {C}onclusions ans relevance : {T}his individual patient data meta-analysis of longitudinal cohort studies found that antihypertensive usewas associated with decreased dementia risk compared with individuals with untreated hypertension through all ages in late life. {I}ndividuals with treated hypertension had no increased risk of dementia compared with healthy controls.},
  keywords = {{ETATS} {UNIS} ; {BRESIL} ; {AUSTRALIE} ; {CHINE} ; {COREE} {DU} {SUD} ; {SINGAPOUR} ; {CENTRAFRIQUE} ; {CONGO} ; {NIGERIA} ; {ALLEMAGNE} ; {ESPAGNE} ; {ITALIE} ; {FRANCE} ; {SUEDE} ; {GRECE}},
  booktitle = {},
  journal = {{JAMA} {N}etwork {O}pen},
  volume = {6},
  numero = {9},
  pages = {e2333353 [18 ]},
  ISSN = {2574-3805},
  year = {2023},
  DOI = {10.1001/jamanetworkopen.2023.33353},
  URL = {https://www.documentation.ird.fr/hor/fdi:010089017},
}