In Brief | Cardiovascular Disease
Evaluating the Impact of antihypertensive deprescribing on cognitive function in elderly patients
Time to read: 01:30
Time to listen: 03:43
Originally Published: 23 September 2024
Sourced: JAMA Internal Medicine
Type of article: In Brief
MedED Catalogue Reference: MCIB004
Category: Cardiovascular Disease
Cross Reference: Neurology, Gerontology
Keywords: antihypertension, cognitive decline, neruology
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Originally published in JAMA Internal Medicine, 23 September 2024.This summary does not represent the original research, nor is it intended to replace the original research. Access the full Disclaimer Information
Deprescribing was defined as either reducing the total number of antihypertensive medications or reducing the dosage by 30% for at least two weeks.
A total of 12,644 residents, with a mean age of 77.7 years and 97.4% being male (12,315), were eligible for the ITT analysis.
Similarly, 12,053 residents, also with a mean age of 77.7 years and 97.4% male (11,739), qualified for the per-protocol analysis.
The primary outcome was cognitive function, measured using the Cognitive Function Scale (CFS), which classifies cognitive status as cognitively intact, mildly impaired, moderately impaired, or severely impaired.
The following findings were recorded:
- 12% of residents experienced worsened cognitive function, while 7.7% showed improvement.
- In the deprescribing group, 10.8% experienced cognitive decline compared to 12.1% in the stable medication group.
- In the per-protocol analysis, deprescribing was associated with a 12% reduction in the odds of worsening cognitive function per 12-week period (odds ratio 0.88, 95% CI) compared to those who continued their medication.
- The benefit of deprescribing was even more pronounced among residents with dementia, who experienced a 16% reduced risk of cognitive decline (odds ratio 0.84, 95% CI).
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