Killing Two Ills with One Pill

Alzheimers disease treatments might help lower heart attack risk

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) The dementia associated with Alzheimer’s disease cannot be cured, but medication is available to improve the ability to think and remember.

Alzheimer’s patients who are being treated for their symptoms might be able to benefit from their treatment in more ways than one, according to the results of a new study. 

The study suggested that certain medications used to treat early stages of Alzheimer’s disease might reduce the risk of heart attacks. 

"Ask your neurologist about treatments for dementia."

The study was conducted by Peter Nordstrom, Professor of geriatric medicine at Umea University in Sweden, and colleagues from other institutions in Sweden.

The aim of the study was to evaluate the effects of medications used to treat Alzheimer’s disease on myocardial infarction (heart attack) in later life.

Cholinesterase inhibitors (ChEIs) are a category of medications used to treat the symptoms of mild Alzheimer’s disease. Three ChEIs — donepezil (brand name Aricept), rivastigmine (brand name Exelon), and galantamine (brand name Reminyl) — are currently used in Alzheimer’s therapy.

These medications may have certain unintended beneficial effects on a major nerve known as the vagus nerve, which controls the heart rate. Some studies have showed that ChEIs also block inflammation.

The researchers obtained data from the Swedish Dementia Registry from May 2007 to December 2010. They looked at more than 7,000 patients with Alzheimer’s disease.

On analyzing the data, the researchers found that compared to patients not taking ChEIs, patients who were taking ChEIs were 38 percent less likely to have a heart attack and 26 percent less likely to die from cardiovascular conditions such as stroke.

The researchers also looked at how the dose of ChEIs affected their results. Patients taking the highest doses of ChEIs had a 65 percent lower chance of having heart attack compared to those not taking ChEIs.

According to Professor Nordstrom, "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 every year among those taking ChEIs compared to those not using them."

The study also considered other medications used for Alzheimer’s dementia to see if they affected the risk of having a heart attack. They looked at memantine (brand name Ebixa), a medication used in the treatment of moderate to advanced Alzheimer’s disease that works in a different manner than ChEIs.

Memantine did not significantly affect the risk of heart attacks.

“Given that this is an observational study, no recommendations can be given to patients based on our results, although we find them of high interest. Nevertheless, intervention studies are needed where patients and prescribing doctors are blinded to medication or placebo before any recommendations can be given for these type of medications with respect to cardiovascular disease,” Professor Nordstrom told DailyRx.

The results of the study were published in June in the European Heart Journal, the flagship journal of the European Society of Cardiology.

The study was funded by the Swedish research council, the Swedish Brain Power consortium, the Swedish Society of Medicine and Foundation for Geriatric Diseases at Karolinska Institutet, the Swedish Dementia Foundation, and the Swedish Association of Local Authorities and Regions. 

Reviewed by: 
Review Date: 
June 3, 2013
Last Updated:
August 7, 2013