碩士 / 慈濟大學 / 公共衛生學系碩士班 / 102 / Objectives: Antihypertensive medications such as calcium channel blockers (CCB), angiotensin receptor blockers (ARB) and angiotensin converting enzyme inhibitors (ACEI) are commonly used for achieving goal blood pressure of hypertensive patients. Previous in vitro or animal studies found that the pharmacological effect of CCB, ARB and ACEI could block the pathogenesis of Alzheimer’s disease (AD), thus preventing the occurrence of AD. However, the findings from observation studies and clinical trials have been debated. The objective of this study is to evaluate the risk of AD among hypertensive patients taking antihypertensive medications including CCB, ARB and ACEI. Methods: A retrospective cohort study was conducted by analyzing the longitudinal health insurance database 2005 (LHID2005) of national health insurance research database(NHIRD) from 2006 to 2010. We identified a total of 16,064 hypertensive patients aged above 60 years old as study cohort. Subjects were grouped into CCB-exposure group (n=3,320), ARB-exposure group (n=714), ACEI-exposure group (n=574) and control group (n=3,446) according to the types and dosage of antihypertensive medications during follow-up period. We used Cox proportional hazard regression model to evaluate the risks of AD for each of three exposure groups and control group separately. Results: Among 16,064 hypertensive cases, 541 (3.4%) AD cases were diagnosed during follow-up period (mean follow-up time=3.1 years). The annual incidence of AD increased with age obviously. The annual incidence rates of AD at CCB, ARB, ACEI and control group were 1.02%, 1.21%, 1.24% and 1.22%, respectively. Analysis results revealed that the risk of AD at CCB group was significantly lower than that of control group (hazard ratio (HR): 0.70, 95% CI: 0.54-0.91). No significant association was observed for either ARB-exposure (HR=0.90, 95% CI: 0.58-1.34) or ACEI-exposure group (HR=0.84, 95% CI: 0.52-1.34). Conclusions: We found results regarding CCB treatment benefits in AD prevention among the elderly hypertensive population. Our findings support recommendations for the use of CCB treatment of hypertension in the elderly.
| Identifer | oai:union.ndltd.org:TW/102TCU00058009 |
| Date | January 2014 |
| Creators | Wu Chia-Liang, 吳家樑 |
| Contributors | Wen Shu-Hui, 溫淑惠 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | zh-TW |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 74 |
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