Telmisartan use linked to reduced risk of Alzheimer's disease and dementia

U.S.A.: According to a study published in the journal, Alzheimer's & Dementia, moderate/high telmisartan exposure was substantially related with a decreased incidence of AD and dementia among African Americans.

Alzheimer's disease (AD) is a neurological ailment that affects a significant number of people and progresses over time. Telmisartan is the only angiotensin II receptor blocker with positive anti-diabetic and renal function effects, which reduces the risk of AD in AAs.

"An important field that could enhance the lives of a wide range of patients is the investigation of race-specific reactions to medicine. Therefore, it is critical to pinpoint the racial impacts of medications using sizable real-world patient datasets and genetic information from people with a variety of ethnic backgrounds," Feixiong Cheng and team stated.

The connection between telmisartan exposure and the course of Alzheimer's disease (AD) was the subject of the authors' investigation.

In order to evaluate potential causal links between AD and telmisartan's target, they carried out race-conscious pharmacoepidemiologic investigations on 5.62 million older people (age 60). They also did Mendelian randomization (MR) analysis on a sizable amount of ethnically diverse genetic data.

Major highlights of the study:

• When AAs were compared to low/no telmisartan exposure, there was a substantial reduction in the incidence of AD (hazard ratio [HR] = 0.77, 95% CI: 0.65-0.91, p-value = 0.0022), but not in non-Hispanic EAs (HR = 0.97, 95% CI: 0.89-1.05, p-value = 0.4110).
• The average hypertension daily dosage and telmisartan's medication possession ratio (MPR) were found to be substantially linked with a stronger reduction in the prevalence of AD and dementia in AAs by sensitivity and sex/age-stratified patient subgroup analyses.
• They discovered AA-specific positive benefits of telmisartan for AD using MR analysis from large genome-wide association studies (GWAS) (over 2 million participants) across AD, hypertension, and diabetes.

The researchers concluded that Telmisartan's favorable benefits on anti-hypertensive, anti-diabetic, and kidney protection may be able to account for its AA-specific therapeutic effects in AD.

REFERENCE

Zhang, P, Hou, Y, Tu, W, et al. Population-based discovery and Mendelian randomization analysis identify telmisartan as a candidate medicine for Alzheimer's disease in African Americans. Alzheimer's Dement. 2022; 1- 12. https://doi.org/10.1002/alz.12819