Trends in the incidence of dementia in people with hypertension in the UK 2000 to 2021

Abstract

INTRODUCTIONWe investigated trends in the incidence of dementia in UK adults with hypertension.METHODSPrimary care electronic health records from IQVIA Medical Research Data UK, previously known as THIN, were used to identify 2,133,118 adults aged ≥40 years with hypertension over 2000 to 2021. The annual incidence rate and average annual percentage change in recorded dementia diagnoses were estimated and stratified by sex, 10‐year age bands, Townsend deprivation quintiles and dementia subtype.RESULTSThe crude incidence rate of dementia in people with hypertension increased from 1.98 (95% confidence internal [CI] 1.89–2.07) per 1000 person‐years at risk (PYAR) in 2000 to 5.29 per 1000 PYAR (95% CI 5.07–5.53) in 2021, corresponding to an average annual increase of 4.1% (95% CI 3.3–5.0). Those aged ≥80 years, the most economically deprived (Townsend = 5), and Alzheimer's disease subtype reported the highest incidence rate within their respective categories.DISCUSSIONThe annual incidence rate of dementia in the hypertensive population has increased over the last 22 years.Highlights New dementia diagnosis in the hypertensive population has increased over 22 years. The Alzheimer's disease subtype reported the highest incidence rate in people with hypertension. Difference in dementia incidence between hypertensive females and males has reduced. Difference in dementia incidence among deprivation categories has reduced in recent years.

Genetically proxied PDE5 inhibition and risk of dementia: a drug target Mendelian randomisation study

“…This selective prescription can introduce bias in studies that fail to adequately exclude the early years of follow-up. This phenomenon was observed in Adesuyan et al's study, where results lost significance following the exclusion of the first three years of follow-up (6).…”

“…Several in vitro and pre-clinical studies have suggested that PDE5 inhibitors may offer protective effects against AD, Vascular dementia (VaD), and Lewy body dementia (LBD) (3). Additionally, three recent cohort studies have found that Sildenafil usage was associated with reduced risk of AD (4)(5)(6). However, despite efforts to minimise bias, these studies remain susceptible to inherent methodological limitations of observational research, such as reverse causality and residual confounding, which could account for the observed protective effects (7).…”