{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T09:22:50Z","timestamp":1787736170870,"version":"build-2784847793"},"reference-count":49,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Geriat Psychiatry"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypertension and dyslipidaemia are key modifiable risk factors of dementia, and the combined use of statins and antihypertensive medications (AHMs) may offer protective benefits. However, evidence on specific combinations remains limited. This study examined associations between dementia risk and the use of statins with angiotensin\u2010II (Ang\u2010II) promoting AHMs (drugs that increase Ang\u2010II formation) compared with statins combined with Ang\u2010II suppressing AHMs (drugs that decrease Ang\u2010II formation).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a prospective study using data from the 45 and Up Study cohort, a large population\u2010based cohort in New South Wales, Australia. Participants aged \u2265 45\u00a0years with hypertension and dyslipidaemia were included if they had concurrent statin and AHM use. Exposure groups were defined as either users of statins and Ang\u2010II promoting AHMs (angiotensin II receptor blockers [ARBs], thiazides, and dihydropyridine calcium channel blockers [DHP CCBs]) or statins and Ang\u2010II suppressing AHMs (angiotensin\u2010converting enzyme inhibitors [ACEIs], beta\u2010blockers [BBs], and non\u2010DHP CCBs). Medication exposure was determined based on a proportion of days covered (PDC \u2265 80%). Baseline characteristics of the two groups were balanced using 1:1 pair propensity score matching. The Cox proportional hazards model was used to estimate hazard ratios (HRs) adjusted for diet, physical activity, comorbidities, and concomitant medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 34,610 matched participants (17,305 per group; a mean age [standard deviation (SD)] of 65.8 (8.8) years; a mean follow\u2010up (SD) of 12.4 (5.1) years), use of a statin plus Ang\u2010II promoting AHM was associated with a 12% lower dementia risk (HR, 0.88; 95% CI, 0.79\u20130.98) and 13% lower all\u2010cause mortality (HR, 0.87; 95% CI, 0.82\u20130.93) compared to statin plus Ang\u2010II suppressing AHM combinations. Combinations of rosuvastatin or atorvastatin with Ang\u2010II promoting AHMs (HR, 0.43; 95% CI, 0.36\u20130.50 and HR, 0.74; 95% CI, 0.64\u20130.84, respectively) conferred greater benefit compared with simvastatin combined with Ang\u2010II promoting AHMs. The effects were consistent across both sexes, with the protective association observed only in the 65\u201374\u2010year age group, and combinations involving ARBs demonstrated superior benefit compared to those with ACEIs. Findings were robust across sensitivity analyses, including applying a competing\u2010risks model for death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Combined therapy with a statin plus Ang\u2010II promoting AHMs, particularly rosuvastatin or atorvastatin with an ARB, was associated with lower dementia risk, suggesting cognitive benefits may inform therapy selection. Future randomised trials should confirm these findings and explore underlying mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/gps.70243","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T07:30:47Z","timestamp":1785310247000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dementia Risk With Combined Statin and Antihypertensive Drugs That Increase Versus Decrease Angiotensin\u2010II Formation: Findings From the 45 and Up Study"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0421-4327","authenticated-orcid":false,"given":"Eyayaw Ashete","family":"Belachew","sequence":"first","affiliation":[{"name":"School of Pharmacy and Pharmacology UTAS Health University of Tasmania  Hobart Australia"},{"name":"Department of Clinical Pharmacy School of Pharmacy College of Medicine and Health Sciences University of Gondar  Gondar 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