Fluke or Trend: Blood Pressure Lowering Medications vs Alzheimer's Disease

Just 3 days ago, I pointed out a study published in Neurology in which the authors concluded that beta blockers lowered one's risk for loss of cognitive function but that angiotensin converting enzyme (ACE) inhibitors, calcium channel blockers, diuretics & vasodilators did not.  Ironically, in that very same issue, a secondary longitudinal data analysis of the Ginkgo Evaluation of Memory Study was published in which the authors concluded that ACE inhibitors, angiotensin II receptor blockers (ARBs) & diuretics reduced risk for Alzheimer's disease.

To arrive at their conclusion, the authors reviewed over 6 years worth of data for 1,928 adults w/normal cognitive function, who were older than 75yo at study entry.  Some benefit was noted w/calcium channel blockers and even beta blockers, too, but w/o statistical significance.  Ironic, isn't it then, that last week's study suggested benefit from beta blockers but not ACE inhibitors.  

So what are we to make of this quandary & contradictory evidence.  First, let's recall that science is never that clear cut & transparent.  Second, in the big scheme of things, 5-6 year studies of 800-1900 participants is neither long nor large enough.  Third, observational studies such as these are useful for developing hypotheses but not for proving cause & effect.  But with all that said, I can't think of a single reason (aside from anaphylactic allergy) not to lower one's blood pressure and pray for secondary benefit, even as we wait for more definitive proof.

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