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Researchers followed more than 7,000 Alzheimer's disease patients in Sweden for more than three years. Those taking cholinesterase inhibitors had a 38 percent lower risk of heart attack, a 26 percent lower risk of death from cardiovascular causes such as stroke and a 36 percent lower risk of death from any cause, compared to those who did not take the drugs.
Patients who took the highest recommended doses of cholinesterase inhibitors (ChEIs) had the lowest risk of heart attack or death -- 65 percent and 46 percent lower, respectively, than those who never took the drugs, according to the study, which was published online June 5 in the European Heart Journal.
"If you translate these reductions in risk into absolute figures, it means that for every 100,000 people with Alzheimer's disease, there would be 180 fewer heart attacks (295 as opposed to 475) and 1,125 fewer deaths from all causes (2,000 versus 3,125) every year among those taking ChEIs compared to those not using them," study author Professor Peter Nordstrom, of Umea University in Sweden, said in a journal news release.
No cure exists for Alzheimer's disease, an age-related brain disorder and the most common form of dementia. However, cholinesterase inhibitors, such as donepezil (brand name Aricept), galantamine (Razadyne, Reminyl) and rivastigmine (Exelon), are prescribed to help manage symptoms and slow disease progression in people with early- to moderate-stage disease.
Previous research has found that these drugs have a beneficial effect on the vagus nerve, which controls heart rate, and may have anti-inflammatory properties.
"As far as we know, this is the first time that the use of ChEIs has been linked to a reduced risk of heart attacks and deaths from cardiovascular disease in general or from any cause," Nordstrom said.
"As this is an observational study, we cannot say that ChEI use is causing the reduction in risk, only that it is associated with a reduction," he said. "However, the strengths of the associations make them very interesting from the clinical point of view, although no clinical recommendations should be made on the basis of the results from our study."
An analysis of previous randomized, controlled trials would produce answers on which clinical recommendations could be based, Nordstrom added.
-- Robert Preidt
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SOURCE: European Heart Journal, news release, June 4, 2013