https://orcid.org/0000-0003-4878-9082
Abstract
Purpose
Antihypertensives may have effects on the brain beyond blood pressure lowering. Ongoing clinical trials aim to evaluate the effectiveness of approved antihypertensives in preventing dementia, including patients with and without hypertension. In order for a dementia prevention strategy using antihypertensives to be effective, it is critical to understand patient concerns about this strategy in both users and non-users of antihypertensives. Thus, this study examined the association between current use of antihypertensive and having concerns about using an antihypertensive as a dementia prevention strategy, as well as sociodemographic factors associated with concerns.
Patients and methods
Cross-sectional, self-administered, web-based survey was conducted among 1661 patients in a large health system in January 2018. Participants reported whether they were currently taking an antihypertensive (yes/no), and what types of hypothetical concerns they have about the idea of taking an antihypertensive to prevent dementia (yes/no, for each of 7 concerns). Associations between the two variables were assessed via logistic regression, and odds ratios with 95% confidence intervals were calculated.
Results
Most respondents were female (77%), 51–70 years of age (64%), and white (89%), with 30% reporting current antihypertensive use. Compared to current users, non-users were more likely to report the five following concerns: side effects from the medication, hassle to take medications, lack of evidence, not wanting to use medications, and already having normal/low blood pressure. Non-users were also less likely to report having no concerns (adjusted OR = 0.3; 95% CI = 0.2–0.4) compared to current users. Younger age and lower income were associated with having more concerns.
Conclusion
Patients not currently using an antihypertensive are more likely to have concerns about using an antihypertensive for dementia prevention, compared to current antihypertensive users. Patient perspectives are important to consider for the implementation of dementia prevention strategies.
Acknowledgements
The authors would like to thank Jane McNamee for her assistance with survey deployment, Kelly Hansen for her assistance with project management, and the members of the Kaiser Permanente Washington Senior Caucus for their important feedback on the initial survey. The sponsor had no role in the design, methods, subject recruitment, data collection, analysis, and preparation of this paper. Results from this manuscript were previously presented at the ISPOR 2019 annual conference in New Orleans, LA, May 2019. The abstract of this manuscript has been published in Value in Health: Lee W, Gray S, Barthold D, et al PIH68 do patient concerns about antihypertensive use as a dementia prevention strategy vary by current use of antihypertensive medication? Value in Health, 2019;22:S193–S194.
Ethics Approval And Informed Consent
The Institutional Review Board at the Kaiser Permanente Washington Health Research Institute approved all study materials and procedures. Participants provided consent upon completing the survey.
Data Availability
Data are available from the corresponding author upon request.
Author Contributions
All authors listed meet the IMCJE guidelines for authorship. All authors contributed to data analysis, drafting, or revising the article, gave final approved of the version to be published and agree to be accountable for all aspects of the work.
Disclosure
Dr Doug Barthold reports personal fees from Omada Health for serving as an analysis consultant for a scientific analysis of Omada’s digital diabetes app., outside the submitted work. Dr Paul K Crane reports grant from Eisai for consulting and travel fees for lecturing at Eisai on cognitively defined Alzheimer’s disease subtypes in 2018, outside the submitted work. The authors report no other conflicts of interest in this work.