OBJECTIVES: There is some evidence that anti-hypertensive medications, specifically beta-blockers improve cognitive functioning and thus may reduce the risk of cognitive impairment. We examined the association of beta-blockers with cognitive impairment among adults (age >21 years) with hypertension and cardiovascular diseases (CVDs).

METHODS: We used a retrospective cross-sectional study design. We derived data from 2015 Medical Expenditure Panel Survey (MEPS). Study participants were adults (age >21 years), with hypertension or CVDs without intracranial injury, Parkinson, Alzheimer's Disease and Related Dementia, and missing information on cognitive impairment (N = 9,068). Cognitive impairment was measured based on 1) confusion or memory loss; 2) problems making decisions; or 3) supervision for participant’s safety. Anti-hypertensive medications were categorized into: 1) beta-blockers; 2) other anti-hypertensives; and 3) no anti-hypertensive medication. We used multivariable survey logistic regressions to examine the association between beta-blockers and cognitive impairment after controlling for biological factors, pain, chronic conditions, socioeconomic status, access to healthcare services, behavioral, socio-cultural and external environment factors.

RESULTS: Overall, 22.50%, 41.40% and 36.10% reported using beta-blockers, other anti-hypertensives, and no anti-hypertensive medications, respectively. The cognitive impairment prevalence was 17.80%. In the unadjusted model, adults who used beta-blockers had higher odds of cognitive impairment (OR= 1.68, 95%CI= 1.39-2.02, p= <0.0001) compared to those without any anti-hypertensive medications. After controlling for pain, beta-blockers were no longer significantly associated with cognitive impairment (AOR= 1.22, 95%CI= 1.00-1.49). In fully adjusted models, AOR for beta blockers was 1.11 (95% CI = 0.88-1.39).

CONCLUSIONS: In this first large, cross-sectional study of the U.S. adults with hypertension and CVDs, we found that beta-blockers were not associate with cognitive impairment. Future prospective studies that include pain management and blood pressure control are needed to confirm our study findings.