Blood pressure drug linked to lower risk of Alzheimer's disease in black patients

Blood pressure drug linked to lower risk of Alzheimer's disease in black patients

Considering how patients from different ethnic groups respond to the same drug could be crucial to finding new treatments for Alzheimer's disease - a condition the Alzheimer's Association had previously classified as a "silent epidemic" among black adults.

A Cleveland Clinic-led study published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association showed that telmisartan, a drug currently prescribed to people with high blood pressure, is associated with a lower risk of Alzheimer's disease, particularly in black patients over the age of 60. Insurance data from millions of adults over 60 did not show the same potential effect in white patients.

The results suggest that future clinical trials should prioritize patients from minority groups to find or strengthen these associations, says Feixiong Cheng, Ph.D., associate staff at the Cleveland Clinic Genomic Medicine Institute.

More than 6 million people in the United States suffer from Alzheimer's disease, the most common form of dementia. Black adults over 60 are 1.5 to twice as likely to develop Alzheimer's disease as white patients. So far, there is only one drug approved to treat a potential underlying cause of Alzheimer's directly in the brain, although there are other ways to address the symptoms.

Considering race-specific drug reactions has the potential to dramatically improve patient care. Identifying these candidate drugs can also provide more information about the disease itself by pointing to the drug’s targets.”

Dr. Feixiong Cheng, Ph.D., associate staff at the Cleveland Clinic Genomic Medicine Institute

Using big data to find new treatments

The team of Dr. Cheng applies innovative research techniques using artificial intelligence and anonymized data from Cleveland Clinic's extensive electronic medical record systems to identify novel targets and reusable drugs for the treatment of Alzheimer's disease. Yuan Hou, Ph.D., a member of Dr. Cheng, and Pengyue Zhang, Ph.D., Indiana University School of Medicine, are co-first authors of the study.

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The laboratory of Dr. Cheng at Cleveland Clinic's Lerner Research Institute is using human genome sequencing data from the Alzheimer's Disease Sequencing Project, a nationwide network aimed at identifying the genetic basis and effective drug targets for Alzheimer's disease.

For this study, researchers used state-of-the-art retrospective cohort analysis to examine data from more than 5 million patients as part of the Alzheimer's Disease Sequencing Project. They found that telmisartan was significantly associated with a reduced incidence of Alzheimer's disease in black participants.

Telmisartan belongs to a group of medicines used to treat high blood pressure by blocking angiotensin II, a hormone that causes blood vessels to narrow. A blood pressure drug that treats high blood pressure differently, lisinopril, did not show the same potential benefits as telmisartan, suggesting that angiotensin II blockers may be helpful in preventing or treating Alzheimer's disease in black patients.

Develop more comprehensive clinical trials

Black patients are more likely to have the comorbidities already associated with Alzheimer's, such as hypertension, diabetes and chronic kidney disease. Researchers are now working to determine how routine medical treatment of these conditions may also be associated with the reduced risk of developing Alzheimer's disease when taking telmisartan.

Although Black patients are more likely to develop Alzheimer's disease and suffer from associated comorbidities, they are chronically underrepresented in clinical trials. Keeping this in mind when recruiting for trials can help create genetic data from diverse populations that is critical for further study and drug discovery, says Dr. Cheng.

The study was supported by the National Institute on Aging of the National Institutes of Health (NIH) and the Translational Therapeutics Core of the Cleveland Alzheimer's Disease Research Center.

Source:

Cleveland Clinic

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