Renin-Angiotensin System Inhibitor Use and Mortality in Older Hypertensive Patients With and Without Dementia: A Nationwide Registry-Based Cohort Study.
M, V.L., MT, H., H, X., J, N., B, P., J, S., I, K., D, R., S, M., & M, M. (2026). Renin-Angiotensin System Inhibitor Use and Mortality in Older Hypertensive Patients With and Without Dementia: A Nationwide Registry-Based Cohort Study.. Journal of clinical hypertension (Greenwich, Conn.). https://doi.org/10.1111/jch.70350
M VL, MT H, H X, J N, B P, J S, et al. Renin-Angiotensin System Inhibitor Use and Mortality in Older Hypertensive Patients With and Without Dementia: A Nationwide Registry-Based Cohort Study.. Journal of clinical hypertension (Greenwich, Conn.). 2026; doi: 10.1111/jch.70350
M VL, MT H, H X, et al. Renin-Angiotensin System Inhibitor Use and Mortality in Older Hypertensive Patients With and Without Dementia: A Nationwide Registry-Based Cohort Study.[J]. Journal of clinical hypertension (Greenwich, Conn.). 2026. DOI: 10.1111/jch.70350.
@article{m2026,
author = {Villa Lopez M and Hoang MT and Xu H and Norgren J and Petek B and Secnik J and Kalar I and Religa D and Maioli S and Mo M},
title = {Renin-Angiotensin System Inhibitor Use and Mortality in Older Hypertensive Patients With and Without Dementia: A Nationwide Registry-Based Cohort Study.},
journal = {Journal of clinical hypertension (Greenwich, Conn.)},
year = {2026},
doi = {10.1111/jch.70350},
note = {PMID: 42625529},
}
TY - JOUR AU - Villa Lopez M AU - Hoang MT AU - Xu H AU - Norgren J AU - Petek B AU - Secnik J AU - Kalar I AU - Religa D AU - Maioli S AU - Mo M TI - Renin-Angiotensin System Inhibitor Use and Mortality in Older Hypertensive Patients With and Without Dementia: A Nationwide Registry-Based Cohort Study. T2 - Journal of clinical hypertension (Greenwich, Conn.) PY - 2026 DO - 10.1111/jch.70350 AN - PMID:42625529 ER -
Cardiovascular risk factors are often undertreated in patients with dementia. Renin-angiotensin system inhibitors (RASI) are first-line treatments for hypertension. We examined the association between RASI and all-cause mortality in hypertensive patients with and without dementia, comparing angiotensin-converting enzyme inhibitors (ACEI) to angiotensin receptor blockers (ARB); and selected individual agents. This nationwide register-based cohort study included data from Swedish national registries 2007-2018. The study included 158 176 hypertensive patients with exposure to RASI medications (21 152 RASI users and 137,024 non-users), after excluding prevalent users. Propensity score matching was used to balance measured confounders. Cox regressions compared mortality risk among RASI users versus non-users, ACEI users versus ARB users, and users of enalapril, ramipril, losartan, and candesartan versus other RASI users. RASI use was associated with lower all-cause mortality (hazard ratio[HR] 0.93, 95% confidence interval[CI] 0.91-0.95, p< 0.001) in the full cohort, and among patients with dementia (HR 0.88, 95% CI 0.85-0.92). Compared to ACEI, ARB were associated with lower mortality in the full cohort (HR 0.90, 95% CI 0.85-0.96), but results were not significant in patients with dementia. The comparison of the individual drugs were consistent with class-level findings. RASI use was associated with lower all-cause mortality among older hypertensive patients, including those with dementia. These observational findings support continued attention to evidence-based hypertension treatment in patients with dementia.