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Angiotensin Receptor-neprilysin Inhibitor Versus Renin-angiotensin System Inhibitor for Dementia Risk in Patients

Wei-Syun Hu1,2, Cheng-Li Lin3

  • 1School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.

Journal of Cardiovascular Pharmacology
|July 5, 2023
PubMed

Insights

Angiotensin receptor-neprilysin inhibitors (ARNI) show a lower risk of new-onset dementia in heart failure (HF) patients compared to renin-angiotensin system inhibitors (RASI). This real-world study highlights ARNI

Area of Science:

  • Cardiology
  • Neurology
  • Pharmacology

Background:

  • Heart failure (HF) is a growing concern with significant comorbidities.
  • Dementia is a prevalent and debilitating condition, particularly in aging populations.
  • The interplay between HF and dementia necessitates research into effective management strategies.

Purpose of the Study:

  • To investigate the impact of angiotensin receptor-neprilysin inhibitors (ARNI) versus renin-angiotensin system inhibitors (RASI) on dementia incidence in heart failure patients.
  • To compare the risk of new-onset dementia between HF patients treated with ARNI and RASI.

Main Methods:

  • A real-world, nationwide registry study involving 18,154 heart failure patients from January 1, 2017, to December 31, 2019.
  • Patients were divided into two groups: those receiving RASI and those receiving ARNI.
  • Cox proportional hazard models were used to calculate adjusted hazard ratios and 95% confidence intervals for dementia incidence.

Main Results:

  • The study included 18,154 patients treated with either RASI or ARNI.
  • After adjusting for age, sex, comorbidities, and medications, the ARNI cohort demonstrated a significantly lower risk of dementia.
  • The adjusted hazard ratio for dementia in the ARNI group compared to the RASI group was 0.83 (95% CI = 0.72, 0.95).

Conclusions:

  • The use of angiotensin receptor-neprilysin inhibitors (ARNI) is associated with a reduced risk of new-onset dementia in patients with heart failure.
  • These findings suggest a potential neuroprotective benefit of ARNI in the HF population.
  • Further research is warranted to elucidate the mechanisms behind this association.

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