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Antihypertensive Drugs May Lower Risk Of Dementia LONDON, ENGLAND -- Oct. 23, 1998 -- High blood pressure is known to be the strongest risk factor for dementia in elderly people. In this week's issue The Lancet, professor Françoise Forette and colleagues from several European hospitals report the findings of a new study showing that elderly people with systolic hypertension (high blood pressure) have a lower risk of dementia if they are treated with antihypertensive drugs. The Systolic Hypertension in Europe (Syst-Eur) trial was set up in 1988 to investigate whether treatment with antihypertensive drugs could reduce the incidence of dementia. The study enrolled 2,418 patients at 106 centres in 19 European countries. Eligible patients were those who had no dementia at the start of the trial, were at least 60 years old and had a blood pressure, when sitting down, of 160 to 219 mm Hg systolic (when the heart contracts) and below 95 mm Hg diastolic (when the heart is relaxed). Active treatment was with an antihypertensive drug (nitrendipine 10 to 40 mg/day) and cognitive function was measured by the mini mental state examination (MMSE). This examination is a questionnaire that provides a score based on 30 simple factors such as whether the patients can orient themselves in time and space, how well they recall things, their short-term memory, attention and ability to calculate. If the patient's score was 23 or less, diagnostic tests were done for dementia with the DSM-III-R criteria (Diagnostic and Statistical Manual of Mental Disorders). Compared with placebo (1,180 patients), active treatment (1,238 patients) reduced the incidence of dementia by 50 percent from 7.7 to 3.7 cases per 1,000 patient-years. This means that if 1,000 hypertensive patients were treated with antihypertensive drugs for five years, an estimated 19 cases of dementia would be prevented. Related Links: The Lancet E-mail this page to a friend or colleague! To print, use this version