A new-user, active-comparator cohort study compared adults aged 65 and over with hypertension taking predominantly receptor-stimulating antihypertensives (ARBs, dihydropyridine calcium channel blockers, thiazides) with those taking receptor-inhibiting classes (ACE inhibitors, beta blockers, non-dihydropyridine calcium channel blockers), in US Medicare claims (n=1,596,034) and the Vanderbilt electronic health record (n=80,267). Over roughly seven years, incident Alzheimer's disease and related dementias were lower in the stimulating group in both sources, at 6.7% against 8.2% in Medicare. The analysis used propensity-score matching and Cox models with time-dependent covariates, but it is observational and has not yet been peer reviewed.
Why it is interesting: Tests a single-cohort pharmacoepidemiological signal on antihypertensive class and dementia in a structurally independent data source, and the direction holds.