Effect of Angiotensin II Receptor Blockers on Alzheimer's Disease Progression: A Population-Based Cohort Study
Author(s)
Hyun Woo Lee, Student1, Seungyeon Kim, PhD2, Byoung Seok Ye, MD, PhD3, Yun Mi Yu, PhD4.
1Department of Pharmaceutical Medicine and Regulatory Sciences, Colleges of Medicine and Pharmacy, Yonsei University, Incheon, Korea, Republic of, 2College of Pharmacy, Dankook University, Cheonan, Korea, Republic of, 3Department of Neurology, College of Medicine, Yonsei University, Seoul, Korea, Republic of, 4Department of Pharmacy and Yonsei Institute of Pharmaceutical Sciences, College of Pharmacy, Yonsei University, Incheon, Korea, Republic of.
1Department of Pharmaceutical Medicine and Regulatory Sciences, Colleges of Medicine and Pharmacy, Yonsei University, Incheon, Korea, Republic of, 2College of Pharmacy, Dankook University, Cheonan, Korea, Republic of, 3Department of Neurology, College of Medicine, Yonsei University, Seoul, Korea, Republic of, 4Department of Pharmacy and Yonsei Institute of Pharmaceutical Sciences, College of Pharmacy, Yonsei University, Incheon, Korea, Republic of.
OBJECTIVES: Angiotensin II receptor blockers (ARBs) have shown potential neuroprotective effects in Alzheimer’s disease (AD), possibly delaying its progression; however, evidence remains limited. This study aimed to evaluate the association between ARB use and AD progression.
METHODS: This retrospective cohort study investigated the effect of ARBs on AD progression using Korean Health Insurance Review and Assessment database. Individuals aged 60-79 years who were diagnosed with AD in 2010 were included. ARB users and non-users were 1:1 propensity score matched based on age, sex, insurance type, comorbid diseases, and concomitant medications. ARB users were further classified as new or previous users based on ARB prescription records from 1 year prior to the index date. Cox proportional hazards regression models were used to assess the association between ARB use and AD progression.
RESULTS: ARB use was significantly associated with a reduced risk of memantine initiation (hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.70-0.89) and mortality (HR = 0.83; 95% CI = 0.76-0.89). Previous ARB users demonstrated a significant reduction in the risk of memantine initiation compared to non-users (HR = 0.77; 95% CI = 0.66-0.89), whereas new users did not (HR = 0.85; 95% CI = 0.71-1.02). Both new and previous ARB users showed a significant reduction in mortality risk, with no difference observed between the groups.
CONCLUSIONS: The findings from this study highlight the potential of ARBs as a disease-modifying treatment option to slow the progression of AD.
METHODS: This retrospective cohort study investigated the effect of ARBs on AD progression using Korean Health Insurance Review and Assessment database. Individuals aged 60-79 years who were diagnosed with AD in 2010 were included. ARB users and non-users were 1:1 propensity score matched based on age, sex, insurance type, comorbid diseases, and concomitant medications. ARB users were further classified as new or previous users based on ARB prescription records from 1 year prior to the index date. Cox proportional hazards regression models were used to assess the association between ARB use and AD progression.
RESULTS: ARB use was significantly associated with a reduced risk of memantine initiation (hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.70-0.89) and mortality (HR = 0.83; 95% CI = 0.76-0.89). Previous ARB users demonstrated a significant reduction in the risk of memantine initiation compared to non-users (HR = 0.77; 95% CI = 0.66-0.89), whereas new users did not (HR = 0.85; 95% CI = 0.71-1.02). Both new and previous ARB users showed a significant reduction in mortality risk, with no difference observed between the groups.
CONCLUSIONS: The findings from this study highlight the potential of ARBs as a disease-modifying treatment option to slow the progression of AD.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD243
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Neurological Disorders