{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:07:10Z","timestamp":1792112830199,"version":"4.4.0"},"reference-count":51,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,5,30]],"date-time":"2018-05-30T00:00:00Z","timestamp":1527638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the cardiovascular (CV) effects of acetylcholinesterase inhibitors (AChEIs) in individuals with dementia<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review and meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Two authors independently searched major electronic databases from inception until June 17, 2017, for longitudinal (without a control group) and cohort (with a control group) studies reporting CV outcomes in relation to AChEIs. Randomized controlled trials were excluded because they included relatively healthy subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Individuals with dementia and controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Changes in CV parameters were summarized using standardized mean differences (SMDs) with 95% confidence intervals (CIs). Event rates were used to assess incidence of hypertension and bradycardia. Incidence of CV events in demented patients versus in healthy controls were compared using hazard ratios (HRs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 4,588 initial hits, 31 studies including 258,540 individuals with dementia and 2,246,592 controls were analyzed. In longitudinal and open\u2010label studies, AChEIs were associated with a significantly greater incidence of hypertension (n=1,573, 4%, 95% CI=2\u20138%, I\n                      <jats:sup>2<\/jats:sup>\n                      =47%) and bradycardia (n=13,703, 2%, 95% CI=1\u20136%, I\n                      <jats:sup>2<\/jats:sup>\n                      =98%). AChEIs were associated with a decrease in heart rate (SMD=\u20131.77, 95% CI=\u20133.58\u20130.03, I\n                      <jats:sup>2<\/jats:sup>\n                      =78%) and an increase in PR interval (SMD=0.10, 95% CI=0.008\u20130.19, I\n                      <jats:sup>2<\/jats:sup>\n                      =3%) from baseline. During a median follow\u2010up of 116 weeks, AChEIs were associated with a significantly lower risk of CV events (stroke, acute coronary syndrome, CV mortality; HR=0.63, 95% CI=0.45\u20130.88, I\n                      <jats:sup>2<\/jats:sup>\n                      =18%), without a significantly greater risk of bradycardic events (HR=1.40, 95% CI=0.76\u20132.59, I\n                      <jats:sup>2<\/jats:sup>\n                      =98%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AChEI therapy may be associated with negative chronotropic and hypertensive effects but also with lower risk of CV events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.15415","type":"journal-article","created":{"date-parts":[[2018,5,31]],"date-time":"2018-05-31T00:45:47Z","timestamp":1527727547000},"page":"1805-1811","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":76,"title":["Cardiovascular Outcomes of Cholinesterase Inhibitors in Individuals with Dementia: A Meta\u2010Analysis and Systematic Review"],"prefix":"10.1111","volume":"66","author":[{"given":"Ahmet Turan","family":"Isik","sequence":"first","affiliation":[{"name":"Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine Dokuz Eylul University Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinar","family":"Soysal","sequence":"additional","affiliation":[{"name":"Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine Dokuz Eylul University Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendon","family":"Stubbs","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology, and Neuroscience King's College London London United Kingdom"},{"name":"South London and Maudsley National Health Service Foundation Trust London United Kingdom"},{"name":"Health, Social Care, and Education Anglia Ruskin University Chelmsford United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Solmi","sequence":"additional","affiliation":[{"name":"Department of Neurosciences University of Padova Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Basso","sequence":"additional","affiliation":[{"name":"Azienda Unit\u00e0 Locale Socio Sanitaria 3 \u201cSerenissima\u201d Mirano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Maggi","sequence":"additional","affiliation":[{"name":"National Research Council Neuroscience Institute, Aging Branch Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Schofield","sequence":"additional","affiliation":[{"name":"Health, Social Care, and Education Anglia Ruskin University Chelmsford United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Veronese","sequence":"additional","affiliation":[{"name":"Azienda Unit\u00e0 Locale Socio Sanitaria 3 \u201cSerenissima\u201d Mirano Italy"},{"name":"National Research Council Neuroscience Institute, Aging Branch Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Mueller","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology, and Neuroscience King's College London London United Kingdom"},{"name":"South London and Maudsley National Health Service Foundation Trust London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,30]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S11718"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2174\/1567205043332009"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afm002"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bph.13010"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000100"},{"key":"e_1_2_6_7_1","unstructured":"WellsG SheaB O'ConnellD et al. 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