EVALUATING THE COGNITIVE BENEFITS OF DIHYDROPYRIDINE CALCIUM CHANNEL BLOCKERS IN DEMENTIA PREVENTION: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Background Dementia is a major global health challenge, and antihypertensive drugs may influence its risk. This study aimed to evaluate whether dihydropyridine calcium channel blockers (DHP-CCBs) reduce the chance for having dementia compared to other antihypertensives. Methods We conducted a systematic search through PubMed and Google Scholar to identify eligible studies between 1989 to 2024, including randomized controlled trials, cohort, and longitudinal studies of adults without baseline dementia that compared DHP-CCBs with other antihypertensives or placebo. Risk of bias was assessed for RCTs and observational studies using the Cochrane RoB2 tool and the MINORS tool, respectively. Results Eleven studies were included, three of which contributed to meta-analysis. Pooled results showed no significant reduction in all-cause dementia risk with DHP-CCBs (RR = 0.89, 95% CI [0.78, 1.02], p = 0.10), with concomitant homogenous pooled studies (I2 = 12.65%, p = 0.32). Sensitivity analysis revealed a significant reduction after excluding one study (RR = 0.89, 95% CI [0.83, 0.95], p = 0.001). Subgroup analysis demonstrated lower dementia risk with DHP-CCBs compared to ACE inhibitors and ARBs , but not against beta-blockers, non-DHPs, or diuretics. Conclusion Overall, DHP-CCBs were not significantly associated with reduced dementia risk. Although subgroup and sensitivity analyses suggest a potential benefit compared with ACE inhibitors and ARBs, the evidence remains limited due to the limited number of eligible studies, incomplete reporting of dosage and administration routes, and insufficient stratification by dementia subtypes. Further well-designed studies with standardized cognitive assessments are warranted to better establish their potential role in dementia prevention.