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PLOS Med: Patients with diabetes+hypertension can reduce the risk of stroke and dementia

Hypertension (HTN) is a major risk factor for stroke and dementia. Stroke can cause brain injury and cause cognitive dysfunction. In addition, chronic hypertension can induce changes in blood -brain barrier (BBB), blood vessel reshaping, and decreased regional cerebral blood flow, which leads to cognitive disorders except stroke.

Type 2 diabetes (T2DM) patients have a higher risk of dementia. It may be due to vascular changes, sugar metabolism changes, and insulin signal conduction may cause neurological degeneration. Among patients with hypertension, the progress of atherosclerosis, arterial reshaping, vascular inflammation and endothelial dysfunction is even more intense.

According to reports, patients with coexistence in T2DM and HTN are more likely to have stroke and dementia, so blood pressure control is an important issue for these patients. Appropriate HTN control has proven to reduce the risk of dementia. In addition to the blood pressure control target of hypertension drugs, the effect of anti -blood pressure drugs to prevent stroke and dementia in HTN is also an important issue.

According to the guide, it is recommended to use vascular tension receptor resistant (ARB) or vascular tensioner converter enzyme inhibitors (ACEI) to treat HTNs of patients with T2DM to protect the kidneys. In addition, the effects of antihypertensive drugs on renin-vascular tension-aldehyde solid ketone (RAAS), insulin resistance (IR) and anti-inflammatory.

In addition to the antihypertensive effect on these patients, ARB has the effect of regulating RAAS and may have multiple types of protection for cognitive capabilities. However, compared with other ARBS, it is still unknown whether the use of tubaltan is better than T2DM and HTN patients better clinical cognition and vascular ending.

To this end, cardiovascular experts from Chang Geng University in Taiwan have carried out relevant research, which aims to compare the long -term results of Titamatan and other ARBs in East Asia T2DM and hypertension patients. It was published in the latest PLOS Medicine magazine.

From 1997 to 2013, the researchers identified 216,6944 T2DM and ARB patients from the Taiwan National Health Insurance Research Database. 65511 patients with qualified patients were divided into two groups: the Tyedaman group and non -tedan ARB group. The main result is the diagnosis of dementia. The secondary results include the diagnosis of Alzheimer’s disease and the occurrence of symptoms of ischemic stroke (IS) with symptoms.

There are 2,280 and 9,120 patients in Telimatan and Non -Tetaman ARB groups, respectively. The risk of dementia in the Damartan group was reduced by 28%(Timartan and Non-Nigaman ARB: 2.19%VS 3.20%; HR = 0.72; 95%CI, 0.53-0.97). When IS is the risk of competition, the dementia risk of the Michadine group is lower (HR = 0.70; 95%CI, 0.51-0.95), all due to death (HR = 0.71; 95%CI, 0.53-0.97) Essence

In addition, in the long-term follow-up, any IS risk of Tamastean users is low (6.84%vs 8.57%; HR = 0.79; 95%CI, 0.67-0.94).

<!-2586: Diabetic terminal page

The current research shows that in East Asian populations, patients with high blood pressure T2DM may be related to lower dementia and any IS incident risk.

references:

Telmisartan Use and Risk of Dementia in Type 2 Diabetes Patients with Hypertension: A Population- Based Cohort Study.

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