Ask your competent? doctor what this means for you. I have no clue which ones I'm using so this obviously is not written for laypersons.
With your elevated chances of dementia post stroke, your competent? doctor and hospital are responsible for preventing that! So your doctor needs to do everything possible! Or are they DOING NOTHING?
With your chances of getting dementia post stroke, you need prevention solutions. YOUR DOCTOR IS RESPONSIBLE FOR PREVENTING THIS!
1. A documented 33% dementia chance post-stroke from an Australian study? May 2012.
2. Then this study came out and seems to have a range from 17-66%. December 2013.`
3. A 20% chance in this research. July 2013.
4. Dementia Risk Doubled in Patients Following Stroke September 2018
The latest here:
Use of common cardiovascular disease drugs and risk of dementia: A case–control study in Swedish national register data
Mozhu Ding and Alexandra M. Wennberg share first authorship.
Abstract
INTRODUCTION
Cardiovascular drug use may help prevent dementia; however, current evidence is mixed. Using a case–control design, we investigated the association between duration and combination of multiple cardiovascular drug classes and incident dementia.
METHODS
From the Swedish national registers, we included 88,065 incident dementia cases aged ≥ 70 at diagnosis between 2011 and 2016 and 880,650 age- and sex-matched controls. Cardiovascular drug use was ascertained from the Prescribed Drug Register.
RESULTS
Long-term users (≥ 5 years) of antihypertensives, diuretics, lipid-lowering drugs (LLDs), and oral anticoagulants (OACs) had statistically significantly fewer dementia diagnoses (odds ratio [OR] 0.75–0.91) than non-users. Antiplatelets use was associated with more dementia diagnoses (OR 1.13–1.25). Use of antihypertensives in combination with diuretics, LLDs, and OACs for ≥ 5 years was associated with fewer dementia diagnoses (OR 0.66–0.84).
DISCUSSION
Preventing dementia via cardiovascular drug pathways may be possible. It is however important to consider the potential long-term negative cognitive effect of antiplatelets.
Highlights
- Use ≥ 5 years of common cardiovascular drugs was associated with lower dementia risk.
- Common cardiovascular drug combination use was associated with lower dementia risk.
- Anti-platelet use of any duration was associated with higher dementia risk.
1 BACKGROUND
Cardiovascular risk factors are leading modifiable risk factors for dementia1 and an estimated 70% of older adults have at least one cardiovascular risk factor or disease.2 Evidence suggests that treatment of cardiovascular risk factors and conditions can target multiple dementia mechanistic pathways.3 Indeed, declining dementia incidence4 seems partially attributable to improved cardiovascular treatment, from medications to public awareness to more stringent care guidelines.5
Studies have primarily investigated single cardiovascular drug classes at a time. For example, evidence has shown that antihypertensive drug use is associated with a lower risk of developing dementia,6 although methodological issues, such as patient group definition and short follow-up time, are limitations in previous studies. Hence, there is a need for more rigorous investigations to implement a cohesive recommendation. Meta-analyses investigating statin use on cognitive outcomes found mixed evidence for their impact on dementia risk, showing both null and potentially protective effects, and the differences in findings may be due to indication bias or duration of treatment.7, 8 A recent Mendelian randomization study showed that polymorphisms in genes coding for drug targets of statins did not associate with Alzheimer's disease (AD) risk; in contrast, the analysis suggested a possible increase in AD risk associated with drug targets of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors.9 Antiplatelet therapy, including aspirin, has also shown mixed results, with a large randomized controlled trial (RCT) investigating low-dose aspirin in community-dwelling older adults over a mean of 4.7 years finding no impact of treatment on the risk of dementia.10 While these studies seem to indicate an association between cardiovascular drug use and lower dementia risk, much of this work has been conducted in specific patient populations, which may not provide evidence for the more general population of older adults with multimorbid cardiovascular risk factors. Further, most studies have limited follow-up time, and it is unclear whether longer exposure could provide additional benefits for cognition. Based on proposed mechanisms of action for these drug classes and the long prodromal period of dementia, we hypothesize that a longer duration of cardiovascular drug use is associated with lower dementia risk and that this will not depend on specific patient populations, benefiting even those in the general population who are multimorbid.
Due to multimorbidity, the use of multiple cardiovascular drug classes is common in old age.11, 12 Hypertension and use of antihypertensive drugs (AHT) are particularly common in the Swedish population and ≈ 70% of women and 80% of men with hypertension diagnosis have another cardiovascular condition.12 Because multiple drug classes target multiple pathways from the cardiovascular to the central nervous system, we hypothesize that combination drug therapy, either combination among antihypertensive classes or combination between antihypertensives and other classes, would be associated with lower risk of dementia but that a ceiling effect will exist.
We designed a case–control study to investigate the association between multiple cardiovascular disease (CVD) drugs and incident dementia. We aimed first to examine how the duration of use of cardiovascular drug classes is associated with dementia risk, and second, to examine how combinations of antihypertensive drug classes and antihypertensives with other drug classes are associated with dementia risk.
No comments:
Post a Comment