Ethnic group may influence the effect of telmisartan
Alzheimer's disease, Gerontology, Neurology, Psychiatry
Indianapolis – Researching and considering the impact of drugs on various ethnic groups can significantly improve patient care. American scientists illustrated this using Alzheimer’s disease in ethnic groups of African descent as an example. Thus, in a large-scale population study (Alzheimer’s disease and dementia 2022; DOI: 10.1002/alz.12819), telmisartan antihypertensive therapy was associated with a significantly lower incidence of Alzheimer’s disease, especially among individuals of African American descent.
African Americans and Americans of European descent differ in the prevalence of Alzheimer’s disease (AD). Thus, in individuals of African descent over 60 years of age, the risk of developing Alzheimer’s disease is 1.5 to two times higher than in Americans of European descent.
In this pharmacoepidemiological study, data on 5.62 million elderly people (aged ≥60 years) were evaluated by ethnic group and examined for statistical associations between telmisartan exposure and the prevalence of AD.
The analysis showed that moderate or high doses of telmisartan were significantly associated with a reduced frequency of AD in African Americans compared to low/low doses of telmisartan (risk ratio [RR] 0.77, 95% confidence interval [CI]: 0.65-0.91, p = 0.0022). However, these associations were not observed in the European descent cohort (RR 0.97, 95% CI: 0.89-1.05, p = 0.4110).
Sensitivity analysis and subgroup analysis by gender and age showed that the pharmacological effects of telmisartan and average daily dosage were significantly associated with a greater reduction in AD and dementia incidence among African Americans over 60 years of age.
Thus, the study authors suggest that the specific mechanism of action of telmisartan as an angiotensin II receptor blocker with partial peroxisome proliferator-activated receptor-gamma (PPAR-γ) agonist properties with beneficial anti-diabetic and renal functional effects may also reduce the risk of AD in African Americans.
Another blood pressure medication with different mechanisms of action, such as lisinopril (ACE inhibitor), did not show the same benefits as telmisartan. This suggests that angiotensin II blockers may play a specific role in the prevention or treatment of Alzheimer’s disease in African Americans.