Imagine you have a door with a special lock that only allows certain people to enter. Now, let’s say these people have a strong protective effect on your brain, shielding it from the risk of Alzheimer’s disease. That’s basically what this study found! Researchers wanted to see if a specific type of medication called angiotensin II receptor blockers (ARBs) could reduce the risk of developing Alzheimer’s. They analyzed data from a large group of people with ischemic heart disease and found that those who used ARBs had a significantly lower risk of Alzheimer’s compared to those who didn’t use the medication. But here’s where it gets even more interesting: they also discovered that ARBs that can cross the blood-brain barrier (BBB-crossing) were even more effective at reducing Alzheimer’s risk. In fact, the higher the cumulative dose or duration of BBB-crossing ARBs, the lower the risk of Alzheimer’s. This suggests that long-term use of these medications may be a promising option for preventing Alzheimer’s in patients with cardiovascular diseases. If you’re interested in learning more, check out the research article linked below!

BackgroundRecent studies on renin-angiotensin system (RAS) inhibitors have reported a reduced risk of Alzheimer’s disease (AD). Nevertheless, the effect of RAS inhibitor type and blood–brain barrier (BBB) permeability on the risk of AD is still unknown.ObjectivesTo assess the effects of RAS inhibitors on the risk of AD based on the type and BBB permeability and investigate the cumulative duration-response relationship.MethodsThis was a population-based retrospective cohort study using the Korean Health Insurance Review and Assessment database records from 2008 to 2019. The data of patients diagnosed with ischemic heart disease between January 2009 and June 2009 were identified for inclusion in the analyses. Propensity score matching was used to balance RAS inhibitor users with non-users. The association between the use of RAS inhibitors and incident AD was evaluated using a multivariate Cox proportional hazard regression model. The results are presented in adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs).ResultsAmong the 57,420 matched individuals, 7,303 developed AD within the follow-up period. While the use of angiotensin-converting enzyme inhibitors (ACEIs) was not significantly associated with AD risk, the use of angiotensin II receptor blockers (ARBs) showed a significant association with reduced risk of incident AD (aHR = 0.94; 95% CI = 0.90–0.99). Furthermore, the use of BBB-crossing ARBs was associated with a lower risk of AD (aHR = 0.83; 95% CI = 0.78–0.88) with a cumulative duration-response relationship. A higher cumulative dose or duration of BBB-crossing ARBs was associated with a gradual decrease in AD risk (P for trend < 0.001). No significant association between the use of ACEIs and the risk of AD was observed regardless of BBB permeability.ConclusionLong-term use of BBB-crossing ARBs significantly reduced the risk of AD development. The finding may provide valuable insight into disease-modifying drug options for preventing AD in patients with cardiovascular diseases.

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