Certain beta-blockers may reduce Alzheimer's risk

This article is from NEJM Journal Watch (NEJM Journal Watch) Beta-Blockers and Alzheimer Disease Beta-blockers and Alzheimer's Disease Relationship Review Author: Jennifer Rose V.
Molano, MD Hypertensive patients taking blood-brain barrier permeability comparison The risk of Alzheimer's disease is lower with high beta-blockers than with less penetrant beta-blockers
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Hypertension is a known risk factor for Alzheimer's disease (AD)
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To determine whether beta-blocker use in hypertensive patients is associated with risk of AD, all-cause dementia, and death, the researchers analyzed 69,091 hypertensive patients (median age, 64 years; 65% women) from the Danish National Registry.
retrospective data
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Of these patients, 24% were taking beta-blockers with low blood-brain barrier (BBB) ​​permeability (atenolol, bisoprolol, and sotalol), and 62% were taking beta-blockers with moderate BBB permeability.
Beta-blockers (metoprolol), 14% taking beta-blockers with high BBB permeability (carvedilol and propranolol)
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Results at a median follow-up of 9.
8 years were as follows: patients taking beta-blockers with high BBB permeability had a lower risk of AD than those taking beta-blockers with low BBB permeability (standardized absolute risk difference, -0.
47%; 95% CI, -0.
85% to -0.
10%); in additional sensitivity analyses, the aforementioned lower risk persisted
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Patients taking beta-blockers with low, moderate, or high BBB permeability had a similar risk of developing all-cause dementia
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After adjustment for covariates, including established AD risk factors, patients taking beta-blockers with intermediate or high BBB permeability had a higher risk of death than those taking beta-blockers with low BBB permeability
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The hypothesis put forward by the authors who commented on the study is that beta-blockers with high BBB permeability may improve CSF metabolic clearance in hypertensive patients, thereby reducing AD risk
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They also suggest that the higher risk of death among patients taking beta-blockers with high BBB permeability than in patients taking beta-blockers with low BBB permeability may be due to the fact that this population has unmeasured High comorbidity burden
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The inclusion of AD biomarkers in future studies will help us better understand how beta-blockers affect AD risk in hypertensive patients
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Reviewed article Beaman EE et al.
Blood–brain barrier permeable β-blockers linked to lower risk of Alzheimer's disease in hypertension.
Brain 2022 Feb 23; [e-pub].
(https://doi.
org/10.
1093/brain/ awac076) Related Reading NEJM Journal Watch NEJM Journal Watch (NEJM Journal Watch) is published by the NEJM Group.
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