Treatment of vascular risk factors in patients with a diagnosis of Alzheimer’s disease: a systematic review

BMC Medicine

Hugh S Markus²  Leonardo Pantoni¹  Raffaella Valenti³ 

[1] Stroke Unit and Neurology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy;Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK;NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy

关键词: Vascular risk factors;    Treatment;    Statin;    Smoking;    Progression;    Hypertension;    Diabetes mellitus;    Dementia;    Cholesterol;    Alzheimer’s disease;   

Others  :  1118239
DOI  :  10.1186/s12916-014-0160-z

 received in 2014-07-05, accepted in 2014-08-20,  发布年份 2014

【 摘 要 】

Background

Increasing evidence suggests vascular risk factors (VRF) play a role in the pathogenesis of Alzheimer’s disease (AD). Epidemiological studies have found associations between VRF and risk of AD. Treating VRF in patients with AD offers a potential treatment option but ineffective treatments should be avoided in this group who are frequently on multiple medications and in whom compliance may be challenging.

Methods

Studies containing information on the treatment of VRF in patients with a diagnosis of AD were identified using a defined search strategy. Randomised controlled trials and observational studies were included.

Results

The pre-specified search strategy retrieved 11,992 abstract articles, and 25 papers including those identified on review of reference lists and reviews met the inclusion criteria. Of these, 11 were randomised controlled trials (RCTs) and 14 observational studies. Observational studies suggested that a VRF package and treatment of hypertension and statin therapy may be associated with improved outcome but these studies suffered from potential bias. The few RCTs performed were mostly small with short duration follow-up, and do not provide clear evidence either way.

Conclusions

Observational data raises the possibility that treating VRF could alter the rate of decline in AD. However RCT data are not yet available to support this hypothesis and to alter clinical practice. RCTs in larger numbers of individuals with longer follow-up, ideally in the early stages of AD, are required to address this potentially important treatment question.

【 授权许可】

   
2014 Valenti et al.; licensee BioMed Central Ltd.

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