Does antihypertensive therapy prevent dementia? Antihypertensive therapy with nitrendipine appears to reduce the risk of dementia by 50% in elderly patients with isolated systolic hypertension, report the Syst-Eur * Investigators. They add that this finding ‘may have important public- health implications in view of the increasing longevity of populations worldwide’. The Syst-Eur study included patients aged ≥ 60 years who had isolated systolic hypertension. 2418 of these patients were involved in the vascular dementia substudy and were randomised to receive active treatment ** (n = 1238) or placebo. Dementia rate halved Over a median duration of follow-up of 2 years, the incidence of dementia was significantly lower among recipients of active treatment compared with placebo (7.7 vs 3.8 cases per 1000 patient-years, respectively). The researchers point out that this would translate to the prevention of 19 cases of dementia if 1000 patients with hypertension were treated for 5 years. Among placebo recipients, the mini mental state examination (MMSE) score decreased when the systolic or diastolic BP decreased. However, among patients who received active treatment, the MMSE score did not change or improved slightly as BP decreased. The primary hypothesis of the present study was that a reduction in BP would protect aginst vascular dementia; however, the incidence of Alzheimer’s disease was also reduced with active treatment in this study. * Systolic Hypertension in Europe [see Inpharma 1095: 3–4, 12 Jul 1997; 800458669] ** Patients received first-line treatment with nitrendipine, to which enalapril and hydrochlorothiazide could subsequently be added. Forette F, et al. Prevention of dementia in randomised double-blind placebo- controlled Systolic Hypertension in Europe (Syst-Eur) trial. Lancet 352: 1347-1351, 24 Oct 1998 800717807

Does antihypertensive therapy prevent dementia?

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Does antihypertensive therapyprevent dementia?

Antihypertensive therapy with nitrendipine appears toreduce the risk of dementia by 50% in elderly patientswith isolated systolic hypertension, report the Syst-Eur*

Investigators.They add that this finding ‘may have important public-

health implications in view of the increasing longevity ofpopulations worldwide’.

The Syst-Eur study included patients aged ≥ 60 yearswho had isolated systolic hypertension. 2418 of thesepatients were involved in the vascular dementiasubstudy and were randomised to receive activetreatment** (n = 1238) or placebo.

Dementia rate halvedOver a median duration of follow-up of 2 years, the

incidence of dementia was significantly lower amongrecipients of active treatment compared with placebo(7.7 vs 3.8 cases per 1000 patient-years, respectively).The researchers point out that this would translate to theprevention of 19 cases of dementia if 1000 patients withhypertension were treated for 5 years.

Among placebo recipients, the mini mental stateexamination (MMSE) score decreased when the systolicor diastolic BP decreased. However, among patientswho received active treatment, the MMSE score did notchange or improved slightly as BP decreased.

The primary hypothesis of the present study was thata reduction in BP would protect aginst vasculardementia; however, the incidence of Alzheimer’sdisease was also reduced with active treatment in thisstudy.* Systolic Hypertension in Europe [see Inpharma 1095: 3–4, 12 Jul1997; 800458669]** Patients received first-line treatment with nitrendipine, to whichenalapril and hydrochlorothiazide could subsequently be added.

Forette F, et al. Prevention of dementia in randomised double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial. Lancet 352:1347-1351, 24 Oct 1998 800717807