Table 2 Observational studies that evaluated whether the treatment of vascular risk factors is associated with a slower progression in patients with Alzheimer’s disease
Vascular risk factors | Study | Population | Diagnosis criteria | Treatment arm and comparator (if any) (n, drug/daily) | Duration of follow-up (months) | Measurement instrument |
|---|---|---|---|---|---|---|
Vascular care package | Deschaintre et al. 2009 [34] | 280 consecutive AD | NINCDS-ADRDA, DSM IV | 208 treated (119 with some VRF treated and 89 with all VRF treated) versus 72 without treatment | 27 | MMSE |
Rosenberg et al. 2008 [35] | 216 AD | NINCDS-ADRDA, DSM III R | Cardiovascular medication (ACE-I, β-blockers, calcium ion channel blockers, diuretics, statins, nitrates, platelet inhibitors or digoxin) | 36 | CDR-Sum | |
Hypertension | Razay et al. 2009 [36] | 141 AD | NINCDS-ADRDA, NINDS-AIREN | Antihypertensive medications | 60 | CAMCOG |
Duron et al. 2009 [37] | 321 consecutive AD | NINCDS-ADRDA, DSM IV | 127 treated with antihypertensive drugs (calcium channel blockers, β-blockers, ACE-I, diuretics, ARB) versus 149 not treated | 34.1 | MMSE | |
Bellew et al. 2004 [38] | 719 mild-to- severe AD | NINCDS-ADRDA | Antihypertensive drugs | 6 | MMSE, ADAS-Cog | |
Li et al. 2010 [39] | 12574 AD | ICD 9 | 3,227 treated with lisinopril versus 476 with ARB versus 8,871 other cardiovascular drugs | 48 | Admission to nursing home | |
12879 AD | 3,333 treated with lisinopril versus 491 with ARB versus 9,055 other cardiovascular drugs | Mortality | ||||
Hajjar et al. 2008 [40] | 62 AD | NINCDS-ADRDA | 15 treated with ACE-I versus 47 untreated | 6 | MMSE, CDT, DO, IADL, SCB | |
Soto et al. 2013 [41] | 616 mild-to-moderate AD | NINCDS-ADRDA | 61 treated with ACE-I versus 189 with other antihypertensive drugs versus 309 without antihypertensive drugs | 48 | MMSE | |
Ellul et al. 2007 [42] | 224 probable AD | NINCDS-ADRDA | 92 treated with antihypertensive drugs (including 20 with ACE-I and 2 with ARB), 12 with statins and 10 with anti-diabetic drugs | 12 | GDS | |
Kehoe et al. 2013 [43] | 3905 AD | Oxford Medical Information System or Read codes and prescriptions | 1,323 treated with ACE-I versus 265 ARB versus 2,315 other antihypertensive drugs | 120 | Hospitalization and mortality | |
Diabetes mellitus | Plastino et al. 2010 [44] | 104 AD | DSM IV | 49 oral anti-diabetic drugs versus 55 insulin oral + anti-diabetic drugs | 12 | MMSE, CGI |
Hypercholesterolaemia | Masse et al. 2005 [45] | 234 AD | NINCDS-ADRDA | 129 were dyslipaemic treated with LLAs (47% with statins) versus 105 untreated | 34.8 | MMSE |
Ellul et al. 2007 [42] | 224 probable AD | NINCDS-ADRDA | 92 treated with antihypertensive drugs (including 20 with ACE-I and 2 with ARB), 12 with statins and 10 with anti-diabetic drugs | 12 | GDS | |
Padala et al. 2012 [48] | 12 AD | - | Statins [atorvastatin (10, 20, 40, 80 mg), simvastatin (10, 40 mg), fluvastatin (20, 40 mg), pravastatin (20 mg), rosuvastatin (10 mg), lovastatin (40 mg)] | 3 (1.5 discontinuation and 1.5 re-challenge) | MMSE, CERAD, ADL, IADL |