INTRODUCTIONCardiovascular 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.METHODSFrom 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.RESULTSLong‐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).DISCUSSIONPreventing 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.

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常见心血管疾病药物的使用和痴呆风险：瑞典国家登记数据中的病例对照研究


引言血管性药物使用可能有助于预防痴呆;然而，目前的证据喜忧参半。使用病例对照设计，我们调查了多种心血管药物类别的持续时间和组合与痴呆事件之间的关联。方法根据瑞典国家登记册，我们纳入了 2011 年至 2016 年诊断时年龄在 70 ≥的 88,065 例事件痴呆病例以及 880,650 例年龄和性别匹配的对照。从处方药登记处确定心血管药物的使用。结果抗高血压药、利尿剂、降脂药 （LLD） 和口服抗凝剂 （OAC） 的长期使用者 （≥ 5 年） 的诊断痴呆 （比值比 [OR] 0.75-0.91） 比非使用者在统计学上显著减少。使用抗血小板药物与更多的痴呆诊断相关 （OR 1.13-1.25）。抗高血压药与利尿剂、LLD 和 OAC 联合使用≥ 5 年与较少的 痴呆 诊断相关 （OR 0.66-0.84）。讨论通过心血管药物途径治疗痴呆可能是可能的。然而，重要的是要考虑抗血小板药物潜在的长期负面认知影响。亮点 ≥使用 5 年常用心血管药物 5 年与较低的痴呆风险相关。常见的心血管药物联合使用与较低的痴呆风险相关。任何持续时间的抗血小板使用都与较高的痴呆风险相关。