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Vascular disease (especially hypertension [HTN]), chronic kidney disease (CKD), and diabetes are risk factors
for Alzheimer's disease (AD) and dementia.
There are differences
between African Americans (AAs) and European Americans (EAs) in the prevalence, risk factors, and symptom presentation of AD.
The purpose of the study was to use large real-world patient datasets and genetic data from different ethnic populations to determine the racial effects
of drugs.
The researchers conducted ethnically disaggregated pharmacoepidemiological studies on 5.
62 million older adults (age ≥ 60 years), using Cox analysis, Kaplan-Meier analysis, and Log-rank tests to study the relationship between
telmisartan exposure and AD outcomes.
This was followed by a Mendelian randomization (MR) analysis of a large number of genetic data from different ethnic groups to test a possible causal relationship
between the target of telmisartan and AD.
Medium/high telmisartan exposure was found to be significantly associated with a reduced incidence of AD in AA compared with low/no telmisartan exposure (hazard ratio [HR] = 0.
77, 95% CI: 0.
65 to 0.
91, P = 0.
0022), but not in non-Hispanic EAs (HR = 0.
97, 95% CI: 0.
89 to 1.
05, P = 0.
4110).
Sensitivity and sex/age stratified patient subgroup analyses found that drug availability (MPR) and average daily dose of hypertension with telmisartan were associated
with a more potent reduction in the incidence of AD and dementia in AAs.
MR analysis (over 2 million people) using large genome-wide association studies (GWAS) across AD, hypertension and diabetes further determined the AA-specific beneficial effects
of telmisartan on AD.
In summary, it is necessary to conduct randomized controlled trials in different ethnic groups of patients to determine the causal relationship and therapeutic effect
of telmisartan with AD.
References:
Population-based discovery and Mendelian randomization analysis identify telmisartan as a candidate medicine for Alzheimer's disease in African Americans.
https://doi.
org/10.
1002/alz.
12819
