Repurposing antihypertensive drugs for the prevention of Alzheimer's disease: a Mendelian randomization study
- PMID: 31335937
- PMCID: PMC7751008
- DOI: 10.1093/ije/dyz155
Repurposing antihypertensive drugs for the prevention of Alzheimer's disease: a Mendelian randomization study
Abstract
Background: Evidence concerning the potential repurposing of antihypertensives for Alzheimer's disease prevention is inconclusive. We used Mendelian randomization, which can be more robust to confounding by indication and patient characteristics, to investigate the effects of lowering systolic blood pressure, via the protein targets of different antihypertensive drug classes, on Alzheimer's disease.
Methods: We used summary statistics from genome-wide association studies of systolic blood pressure and Alzheimer's disease in a two-sample Mendelian randomization analysis. We identified single-nucleotide polymorphisms (SNPs) that mimic the action of antihypertensive protein targets and estimated the effect of lowering systolic blood pressure on Alzheimer's disease in three ways: (i) combining the protein targets of antihypertensive drug classes, (ii) combining all protein targets and (iii) without consideration of the protein targets.
Results: There was limited evidence that lowering systolic blood pressure, via the protein targets of antihypertensive drug classes, affected Alzheimer's disease risk. For example, the protein targets of calcium channel blockers had an odds ratio (OR) per 10 mmHg lower systolic blood pressure of 1.53 [95% confidence interval (CI): 0.94 to 2.49; p = 0.09; SNPs = 17]. We also found limited evidence for an effect when combining all protein targets (OR per 10 mmHg lower systolic blood pressure: 1.14; 95% CI: 0.83 to 1.56; p = 0.41; SNPs = 59) and without consideration of the protein targets (OR per 10 mmHg lower systolic blood pressure: 1.04; 95% CI: 0.95 to 1.13; p = 0.45; SNPs = 153).
Conclusions: Mendelian randomization suggests that lowering systolic blood pressure via the protein targets of antihypertensive drugs is unlikely to affect the risk of developing Alzheimer's disease. Consequently, if specific antihypertensive drug classes do affect the risk of Alzheimer's disease, they may not do so via systolic blood pressure.
Keywords: Alzheimer’s disease; Mendelian randomization; antihypertensive drugs; drug repurposing; hypertension.
© The Author(s) 2019. Published by Oxford University Press on behalf of the International Epidemiological Association.
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Comment in
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Comparison with randomized controlled trials as a strategy for evaluating instruments in Mendelian randomization.Int J Epidemiol. 2020 Aug 1;49(4):1404-1406. doi: 10.1093/ije/dyz236. Int J Epidemiol. 2020. PMID: 31764983 No abstract available.
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Commentary: Using human genetics to guide the repurposing of medicines.Int J Epidemiol. 2020 Aug 1;49(4):1140-1146. doi: 10.1093/ije/dyaa015. Int J Epidemiol. 2020. PMID: 32097451 Free PMC article. No abstract available.
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