Milka-Maaria Juntunen, Suleiman Kamau, Ashlee Oikarainen, Miro Koskenranta, Heli Kuivila, Paula Ropponen, Kristina Mikkonen
The experiences and perceptions of nurse educators of culturally and linguistically diverse nursing students' competence development - Qualitative study
Nurse education today
hypertension modifiable risk factor dementia affecting 70 individuals older 60 lowering dementia risk preferential treatment antihypertensive medication ahm classes otherwise equivalent indication could offer costeffective safe accessible approach reducing dementia incidence globally certain ahmclasses associated lower dementia risk potentially attributable angiotensiniireceptor angii stimulating properties previous study results inconclusive possibly due heterogeneous methodology limited power aimed comprehensively investigate associations ahm subclasses dementia risk using largescale continuous realworld prescription outcome data primary care used data three dutch general practice registration networks primary endpoints clinical diagnosis incident allcause dementia mortality using cox regression analysis timedependent covariates compared use angiotensinconverting enzyme inhibitors acei angiotensin receptor blockers arbs beta blockers calcium channel blockers ccbs diuretics angiistimulating angiiinhibiting ahm 133355 ahmusing participants 5877 44 developed dementia 14079 106 died median followup 76 interquartile range 41110 years compared acei arbs hr 086 95 ci 080092 beta blockers hr 081 95 ci 075087 ccbs hr 077 95 ci 071084 diuretics hr 065 95 ci 061070 associated significantly lower dementia risks regarding competing risk death beta blockers hr 121 95 ci 115127 diuretics hr 169 95 ci 160178 associated higher ccbs similar arbs lower hr 083 95 ci 080087 mortality risk dementia hr 088 95 ci 082095 mortality risk hr 086 95 ci 082091 lower angiistimulating versus angiiinhibiting ahm interactions sex diabetes cardiovascular disease number ahm used among patients receiving ahm arbs ccbs angiistimulating ahm associated lower dementia risk without excess mortality explaining results extensive subgroup sensitivity analyses suggested confounding indication importantly influence findings dementia risk may influenced ahmclasses angiotensiniireceptor stimulating properties rct comparing bp treatment different ahm classes dementia outcome warranted netherlands organisation health research development zonmw stoffelshornstra foundation