Browse by author
Lookup NU author(s): Muzuki Ueda, Dr Daniel ErskineORCiD, Professor Alan ThomasORCiD, Dr Calum HamiltonORCiD, Dr Paul DonaghyORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group.. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.Background: Angiotensin receptor blockers (ARB) may be associated with a lower risk of a clinical dementia diagnosis. This study investigated the association between ARB use during life and postmortem dementia neuropathology, compared with angiotensin-converting enzyme inhibitors (ACEI) use. Method: Cases with documented ACEI (n=257) or ARB (n=102) use, regardless of dementia pathology, were selected from the UK Brain Banks Network dataset. Pathology was categorised as either ‘significant’ pathology (Thal amyloid phase >3, Braak neurofibrillary tangle stage >3, Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) score of moderate/high density and Lewy body (LB) Braak >0 or cortical/limbic/neocortical LB pathology) or ‘not significant’. Results: The ARB group was less likely to have Alzheimer’s disease (AD) pathology compared with the ACEI group: Thal amyloid (adjusted OR (AOR) 0.59 (95% CI 0.36 to 0.97), p=0.038), Braak neurofibrillary tangle (AOR 0.61 (95% CI 0.38 to 0.98), p=0.041) and CERAD neuritic plaque (AOR 0.58 (95% CI 0.35 to 0.96), p=0.035). LB pathology did not differ significantly between ARB and ACEI groups, though use of either ACEI or ARB was associated with a lower likelihood of LB pathology (AOR 0.27 (95% CI 0.21 to 0.36), p<0.001). Conclusion: ARB use is associated with a lower risk of AD pathology. The association between ARB/ACEI use and LB pathology requires further investigation.
Author(s): Ueda M, Erskine D, Thomas A, Hamilton C, Donaghy PC
Publication type: Article
Publication status: Published
Journal: BMJ Neurology Open
Year: 2026
Volume: 8
Issue: 1
Online publication date: 09/04/2026
Acceptance date: 17/03/2026
Date deposited: 06/05/2026
ISSN (electronic): 2632-6140
Publisher: BMJ Publishing Group
URL: https://doi.org/10.1136/bmjno-2025-001342
DOI: 10.1136/bmjno-2025-001342
Data Access Statement: Data are available upon reasonable request. All data supporting these analyses are available through the UK Brain Banks Network.
Altmetrics provided by Altmetric
