A new study using data from the 45 and Up Study has found that a commonly prescribed class of blood pressure medications may be linked to a significantly lower risk of developing dementia.
Researchers from the University of Tasmania analysed data from more than 50,000 Australians with hypertension over an average of 11 years, comparing two widely used types of medication: angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACE inhibitors).
They found that people taking ARBs had a 28% lower risk of developing dementia compared to those taking ACE inhibitors.
A potential new pathway for prevention
With more than 400,000 Australians now living with dementia and no cure available, prevention is a major public health priority.
High blood pressure is a known risk factor for dementia, but this study suggests that the type of medication used to treat it may also play a role in long-term brain health.
“Our findings suggest that not all blood pressure medications have the same impact on long-term brain health. While both types are effective for managing hypertension, ARBs may offer additional benefits when it comes to reducing dementia risk. Further research is needed, but this opens up an important new avenue for prevention,” says first author Eyayaw Ashete Belachew.
Insights only possible through long-term data
The findings were made possible through the 45 and Up Study – one of the largest longitudinal studies of ageing in the world – using the Sax Institute’s Chronic Conditions Umbrella Program Linkage (CUPL) to securely connect participant survey data with hospital, medication and mortality records.
By following people over more than a decade, researchers were able to examine how everyday treatment decisions may influence health outcomes years later.
Importantly, the analysis accounted for key lifestyle factors such as diet and physical activity, which are often missing from similar studies but play an important role in dementia risk.
Not all medications are equal
While both ARBs and ACE inhibitors are widely used and effective for managing blood pressure, the study found meaningful differences between them.
Some ARBs including olmesartan (Benicar), candesartan (Atacand) and telmisartan (Micardis), were associated with particularly strong reductions in dementia risk. These findings are exploratory but point to potential differences between individual medications.
Broader impacts on health
In addition to reduced dementia risk, ARB use was also associated with:
- Lower overall risk of death
- Lower risk of death related to dementia
Together, these findings suggest the potential for broader benefits across ageing and health.
Supporting better decisions through evidence
This research highlights how long-term studies like 45 and Up are helping to answer complex questions about health and ageing – providing evidence that can inform clinical practice, policy and individual decision-making.
While further research is needed, the results offer an important step towards understanding how dementia risk might be reduced through existing, widely used treatments.
