CARDIOVASCULAR EFFECTS OF CHOLINESTERASE INHIBITORS FOR THE TREATMENT OF ELDERLY PATIENTS WITH DEMENTIA
Main Article Content
Keywords
Dementia, Cardiovascular System, Cholinesterase Inhibitors, Neurology, Elderly
Abstract
Objective: The study aimed to raise awareness of the potential cardiovascular hazards associated with cholinesterase inhibitor therapy in elderly dementia patients.
Background: Cholinesterase inhibitors, which increase levels of the neurotransmitter acetylcholine, are commonly used to treat Alzheimer's disease. These medications aid memory and promote cell-to-cell contact, but they also pose significant cardiac-related risks.
Methods: A bibliographic search utilizing the Boolean operator AND was conducted as part of an integrative literature review. Databases searched included Cholesterol Inhibitors, Dementia, Older people, and the cardiovascular system; an Online Scientific Electronic Library; and an Online Medical Literature Analysis and Retrieval System (MEDLINE).
Results: Six papers were identified and reviewed. The findings highlighted various cardiovascular issues linked to cholinesterase inhibitor use, including arrhythmias, stroke, systemic arterial hypertension, syncope, postural hypotension, and bradycardia.
Conclusions: The review underscores the necessity for continuous evaluation of patients undergoing cholinesterase inhibitor therapy. Adjustments in treatment should be made considering the patient's medical history, current health status, and evolving conditions to mitigate cardiovascular risks.
References
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11. Gajendra, K., Pratap, G., Poornima, D., Shantaram, M., & Ranjita, G. (2024). Natural acetylcholinesterase inhibitors: A multi-targeted therapeutic potential in Alzheimer's disease. European Journal of Medicinal Chemistry Reports, 100154.
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19. Mok, P. L., Carr, M. J., Guthrie, B., Morales, D. R., Sheikh, A., Elliott, R. A., . . . Ashcroft, D. M. (2024). Multiple adverse outcomes associated with antipsychotic use in people with dementia: population-based matched cohort study: BMJ, 385.
20. Muğlu, H., Yakan, H., Erdoğan, M., Topal, F., Topal, M., Türkeş, C., & Beydemir, Ş. (2024). Novel asymmetric biscarbothioamides as Alzheimer's disease associated cholinesterase inhibitors: synthesis, biological activity, and molecular docking studies—New Journal of Chemistry.
21. Nematillayevna, S. D., & Temirpulotovich, T. B. (2024). Features of non-psychotic diseases and cognitive disorders in organic brain damage of vascular genesis in older adults. Amaliy va tibbiyot fanlari ilmiy jurnali, 3(2), 124-130.
22. Nham, T., Garcia, M. C., Tsang, K. L. J., Silva, J. M., Schneider, T., Deng, J., . . . Holbrook, A. (2024). Proarrhythmic major adverse cardiac events with donepezil: A systematic review with meta‐analysis. Journal of the American Geriatrics Society.
23. Odenigbo, N., Nkemjika, S., Atolagbe, A., Nwabueze, C., Olwit, C., Lawrence, J., & Olupona, T. (2024). Donepezil-induced bradycardia in a schizophrenic patient with comorbid neurocognitive disorder: a case report and review of the literature. Journal of Medical Case Reports, 18(1), 129.
24. Park, J. S., Choi, S. B., Jang, W. S., Kim, J., & Ham, W. S. (2024). Risks of Dementia After Treatment with an Anticholinergic, Beta-3 Agonist, or Combination of Both for an Overactive Bladder: A Korean National Cohort Study. European Urology Focus.
25. Pinto, S. M. (2024). Geriatric Considerations: Medical Comorbidities and Principles of Medical Management Acute Care Neuroconsultation and Neurorehabilitation Management (pp. 249-263): Springer.
26. Possemis, N., Verhey, F., Prickaerts, J., Blokland, A., & Ramakers, I. (2024). A proof of concept phase II study with the PDE-4 inhibitor roflumilast in patients with mild cognitive impairment or mild Alzheimer’s disease dementia (ROMEMA): study protocol of a double-blind, randomized, placebo-controlled, between-subjects trial. Trials, 25(1), 162.
27. Reuben, D. B., Kremen, S., & Maust, D. T. Dementia Prevention and Treatment: A Narrative Review. JAMA Internal Medicine.
28. Riemma, M. A., Mele, E., Donniacuo, M., Telesca, M., BELLOCCHIO, G., Castaldo, G., . . . Urbanek, K. Glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter two inhibitors, antidiabetic drugs in heart failure and cognitive impairment: potential mechanisms of the protective effects. Frontiers in Pharmacology, 15, 1422740.
29. Shahim, B., Xu, H., Haugaa, K., Zetterberg, H., Jurga, J., Religa, D., & Eriksdotter, M. (2024). Cholinesterase inhibitors are associated with reduced mortality in patients with Alzheimer's disease and previous myocardial infarction. European Heart Journal-Cardiovascular Pharmacotherapy, 10(2), 128-136.
30. Szilcz, M., Wastesson, J. W., Calderón‐Larrañaga, A., Prieto‐Alhambra, D., Blotière, P. O., Maura, G., & Johnell, K. (2024). Cholinesterase inhibitors and non‐steroidal anti‐inflammatory drugs and the risk of peptic ulcers: A self‐controlled study. Journal of the American Geriatrics Society, 72(2), 456-466.
31. Talwar, A., Chatterjee, S., Sherer, J., Abughosh, S., Johnson, M., & Aparasu, R. R. (2024). Cumulative Anticholinergic Burden and its Predictors among Older Adults with Alzheimer’s Disease Initiating Cholinesterase Inhibitors. Drugs & Aging, 41(4), 339-355.
32. Toribio‐Fernandez, R., Ceron, C., Tristão‐Pereira, C., Fernandez‐Nueda, I., Perez‐Castillo, A., Fernandez‐Ferro, J., . . . Cortes‐Canteli, M. (2024). Oral anticoagulants: A plausible new treatment for Alzheimer's disease? British Journal of Pharmacology, 181(6), 760-776.
33. Yilmaz, M. K. (2024). The effect of gabapentin and pregabalin on agitation in dementia: Case series of ten patients. Revue Neurologique.
34. Zhang, N., Gan, L., Xiang, G., Xu, J., Jiang, T., Li, Y., . . . Liu, Y. (2024). Cholinesterase inhibitors-associated torsade de pointes/QT prolongation: a real-world pharmacovigilance study—frontiers in Pharmacology, 14, 1343650.
35. Zhang, Y., Sun, Y., Hu, X., Yao, Y., & Wang, J. (2024). The value of cholinesterase inhibitors for improving neuropsychiatric and functional assessment scores in patients with Alzheimer disease: a systematic review and meta-analysis of placebo-controlled RCTs. International Journal of Surgery, 110(6), 3937-3945.
36. Zuliani, G., Zuin, M., Romagnoli, T., Polastri, M., Cervellati, C., & Brombo, G. (2024). Acetyl-cholinesterase-inhibitors reconsidered. A narrative review of post-marketing studies on Alzheimer’s disease. Aging Clinical and Experimental Research, 36(1), 1-11.
2. Akhtar, A., Singh, S., Kaushik, R., Awasthi, R., & Behl, T. (2024). Types of memory, dementia, Alzheimer’s disease, and their various pathological cascades as targets for potential pharmacological drugs. Ageing Research Reviews, 102289.
3. Alageel, N. A., Hughes, C. M., Alwhaibi, M., Alkeridy, W., & Barry, H. E. (2024). Potentially inappropriate prescribing for people with dementia in ambulatory care: a cross-sectional observational study. BMC geriatrics, 24(1), 328.
4. Arjmandi-Rad, S., Vestergaard Nieland, J. D., Goozee, K. G., & Vaseghi, S. (2024). The effects of different acetylcholinesterase inhibitors on EEG patterns in patients with Alzheimer’s disease: A systematic review. Neurological Sciences, 45(2), 417-430.
5. Beigh, S., Adnan, R., Abdulaziz, A.-J., Abdullah, S., Nasser, N., Ghazzay, R., . . . Alshehri, M. A. (2024). Dementia and Multimorbidity Trends in Al-Baha, Saudi Arabia: An Analytical Retrospective Study Using Records-Based Data. Cureus, 16(1).
6. Carotenuto, A., Andreone, V., Amenta, F., & Traini, E. (2024). Effect of Cholinergic Precursor Choline Alphoscerate Treatment in Mild Cognitive Dysfunction: A Randomized Controlled Trial. Medicina, 60(6), 925.
7. Crestini, A., Carbone, E., Rivabene, R., Ancidoni, A., Rosa, P., Tata, A. M., . . . Lacorte, E. (2024). A Systematic Review on Drugs Acting as Nicotinic Acetylcholine Receptor Agonists in Treating Dementia. Cells, 13(3), 237.
8. Deblier, I., Dossche, K., Vanermen, A., & Mistiaen, W. (2024). Dementia Development during Long-Term Follow-Up after Surgical Aortic Valve Replacement with a Biological Prosthesis in a Geriatric Population. Journal of Cardiovascular Development and Disease, 11(5), 136.
9. Elhalag, R. H., Chèbl, P., Bayoumy, N. M., Hassan, N. A. I. F., Hagar, H., Abowafia, M., . . . Motawea, K. R. (2024). The risk of bone fractures in dementia patients receiving acetylcholinesterase inhibitors a meta-analysis. Annals of Medicine and Surgery, 10.1097.
10. Fantuzzi, A. (2024). Agitation and aggressiveness in Alzheimer’s disease: focus on neurotransmission mechanisms and pharmacological treatments. Università di Parma. Dipartimento di Medicina e Chirurgia.
11. Gajendra, K., Pratap, G., Poornima, D., Shantaram, M., & Ranjita, G. (2024). Natural acetylcholinesterase inhibitors: A multi-targeted therapeutic potential in Alzheimer's disease. European Journal of Medicinal Chemistry Reports, 100154.
12. Havreng-Théry, C., Oquendo, B., Zolnowski-Kolp, V., Krolak-Salmon, P., Bertin-Hugault, F., Lafuente-Lafuente, C., & Belmin, J. (2024). Cholinesterase inhibitors and memantine are associated with reduced mortality in nursing home residents with dementia: a longitudinal observational study. Alzheimer's Research & Therapy, 16(1), 117.
13. Huang, L., Meir, J., Frishman, W. H., & Aronow, W. S. (2024). Cardiovascular Disease and Dementia: Exploring Intersections, Risks, and Therapeutic Challenges. Cardiology in Review, 10.1097.
14. Ip, B. Y. M., Ko, H., Lam, B. Y. K., Au, L. W. C., Lau, A. Y. L., Huang, J., . . . Leung, T. W. H. (2024). Current and future treatments of vascular cognitive impairment. Stroke, 55(4), 822-839.
15. Joseph, M., Cameron-Carter, H., & Akinyemi, E. (2024). Major Neurocognitive Disorder Due to Vascular Disease Treatment of Psychiatric Disorders Among Older Adults (pp. 17-25): Springer.
16. Joshi, P., Patel, N., & Gopalakrishnan, G. (2024). Major Neurocognitive Disorders Due to Alzheimer's Disease Treatment of Psychiatric Disorders Among Older Adults (pp. 3-16): Springer.
17. Khalid, M. (2024). Vascular dementia. InnovAiT, 17(5), 224-229.
18. Liu, P., X., Chen, J., Zhang, Y., Chen, J., Yu, L., & Shou, Z. (2024). Butylphthalide combined with donepezil for the treatment of vascular dementia: a meta-analysis. Journal of International Medical Research, 52(3), 03000605231223081.
19. Mok, P. L., Carr, M. J., Guthrie, B., Morales, D. R., Sheikh, A., Elliott, R. A., . . . Ashcroft, D. M. (2024). Multiple adverse outcomes associated with antipsychotic use in people with dementia: population-based matched cohort study: BMJ, 385.
20. Muğlu, H., Yakan, H., Erdoğan, M., Topal, F., Topal, M., Türkeş, C., & Beydemir, Ş. (2024). Novel asymmetric biscarbothioamides as Alzheimer's disease associated cholinesterase inhibitors: synthesis, biological activity, and molecular docking studies—New Journal of Chemistry.
21. Nematillayevna, S. D., & Temirpulotovich, T. B. (2024). Features of non-psychotic diseases and cognitive disorders in organic brain damage of vascular genesis in older adults. Amaliy va tibbiyot fanlari ilmiy jurnali, 3(2), 124-130.
22. Nham, T., Garcia, M. C., Tsang, K. L. J., Silva, J. M., Schneider, T., Deng, J., . . . Holbrook, A. (2024). Proarrhythmic major adverse cardiac events with donepezil: A systematic review with meta‐analysis. Journal of the American Geriatrics Society.
23. Odenigbo, N., Nkemjika, S., Atolagbe, A., Nwabueze, C., Olwit, C., Lawrence, J., & Olupona, T. (2024). Donepezil-induced bradycardia in a schizophrenic patient with comorbid neurocognitive disorder: a case report and review of the literature. Journal of Medical Case Reports, 18(1), 129.
24. Park, J. S., Choi, S. B., Jang, W. S., Kim, J., & Ham, W. S. (2024). Risks of Dementia After Treatment with an Anticholinergic, Beta-3 Agonist, or Combination of Both for an Overactive Bladder: A Korean National Cohort Study. European Urology Focus.
25. Pinto, S. M. (2024). Geriatric Considerations: Medical Comorbidities and Principles of Medical Management Acute Care Neuroconsultation and Neurorehabilitation Management (pp. 249-263): Springer.
26. Possemis, N., Verhey, F., Prickaerts, J., Blokland, A., & Ramakers, I. (2024). A proof of concept phase II study with the PDE-4 inhibitor roflumilast in patients with mild cognitive impairment or mild Alzheimer’s disease dementia (ROMEMA): study protocol of a double-blind, randomized, placebo-controlled, between-subjects trial. Trials, 25(1), 162.
27. Reuben, D. B., Kremen, S., & Maust, D. T. Dementia Prevention and Treatment: A Narrative Review. JAMA Internal Medicine.
28. Riemma, M. A., Mele, E., Donniacuo, M., Telesca, M., BELLOCCHIO, G., Castaldo, G., . . . Urbanek, K. Glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter two inhibitors, antidiabetic drugs in heart failure and cognitive impairment: potential mechanisms of the protective effects. Frontiers in Pharmacology, 15, 1422740.
29. Shahim, B., Xu, H., Haugaa, K., Zetterberg, H., Jurga, J., Religa, D., & Eriksdotter, M. (2024). Cholinesterase inhibitors are associated with reduced mortality in patients with Alzheimer's disease and previous myocardial infarction. European Heart Journal-Cardiovascular Pharmacotherapy, 10(2), 128-136.
30. Szilcz, M., Wastesson, J. W., Calderón‐Larrañaga, A., Prieto‐Alhambra, D., Blotière, P. O., Maura, G., & Johnell, K. (2024). Cholinesterase inhibitors and non‐steroidal anti‐inflammatory drugs and the risk of peptic ulcers: A self‐controlled study. Journal of the American Geriatrics Society, 72(2), 456-466.
31. Talwar, A., Chatterjee, S., Sherer, J., Abughosh, S., Johnson, M., & Aparasu, R. R. (2024). Cumulative Anticholinergic Burden and its Predictors among Older Adults with Alzheimer’s Disease Initiating Cholinesterase Inhibitors. Drugs & Aging, 41(4), 339-355.
32. Toribio‐Fernandez, R., Ceron, C., Tristão‐Pereira, C., Fernandez‐Nueda, I., Perez‐Castillo, A., Fernandez‐Ferro, J., . . . Cortes‐Canteli, M. (2024). Oral anticoagulants: A plausible new treatment for Alzheimer's disease? British Journal of Pharmacology, 181(6), 760-776.
33. Yilmaz, M. K. (2024). The effect of gabapentin and pregabalin on agitation in dementia: Case series of ten patients. Revue Neurologique.
34. Zhang, N., Gan, L., Xiang, G., Xu, J., Jiang, T., Li, Y., . . . Liu, Y. (2024). Cholinesterase inhibitors-associated torsade de pointes/QT prolongation: a real-world pharmacovigilance study—frontiers in Pharmacology, 14, 1343650.
35. Zhang, Y., Sun, Y., Hu, X., Yao, Y., & Wang, J. (2024). The value of cholinesterase inhibitors for improving neuropsychiatric and functional assessment scores in patients with Alzheimer disease: a systematic review and meta-analysis of placebo-controlled RCTs. International Journal of Surgery, 110(6), 3937-3945.
36. Zuliani, G., Zuin, M., Romagnoli, T., Polastri, M., Cervellati, C., & Brombo, G. (2024). Acetyl-cholinesterase-inhibitors reconsidered. A narrative review of post-marketing studies on Alzheimer’s disease. Aging Clinical and Experimental Research, 36(1), 1-11.
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Jun 24, 2024
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How to Cite
Dr. Avrina Kartika Ririe MD, Mandeep Kaur, Araj Siddiqui, Ellen Y. Huang, Maudlyn O. Etekochay, Dr. Alexander Edo Tondas MD, Venkata Anirudh Chunchu, & Tariq Rafique. (2024). CARDIOVASCULAR EFFECTS OF CHOLINESTERASE INHIBITORS FOR THE TREATMENT OF ELDERLY PATIENTS WITH DEMENTIA. Journal of Population Therapeutics and Clinical Pharmacology, 31(6), 2910-2919. https://doi.org/10.53555/jptcp.v31i6.7163
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Author Biographies
Dr. Avrina Kartika Ririe MD
Staff, Department of Brain & Heart Center, Mohammad Hoesin General Hospital, Indonesia
Mandeep Kaur
MD, Department Internal Medicine, HCA Capital Regional Med Center 2626 Capital Medical Blvd, Tallahassee, FL 32308, USA
Araj Siddiqui
Medical Officer, Accident and Emergency Department, Bahria International Hospital, Pakistan
Ellen Y. Huang
MD, Pre-Clinical MD Student, Caribbean Medical University
Maudlyn O. Etekochay
MPH, MBA, Clinical QI Consultant, Inova Hospital, Department of Quality Improvement, USA
Dr. Alexander Edo Tondas MD
Head of the Department, Department of Brain & Heart Center, Mohammad Hoesin General Hospital, Indonesia
Venkata Anirudh Chunchu
Medical Student, Avalon University School of Medicine, Curacao
Tariq Rafique
Assistant Professor Dadabhoy Institute of Higher Education, Karachi, Pakistan
How to Cite
Dr. Avrina Kartika Ririe MD, Mandeep Kaur, Araj Siddiqui, Ellen Y. Huang, Maudlyn O. Etekochay, Dr. Alexander Edo Tondas MD, Venkata Anirudh Chunchu, & Tariq Rafique. (2024). CARDIOVASCULAR EFFECTS OF CHOLINESTERASE INHIBITORS FOR THE TREATMENT OF ELDERLY PATIENTS WITH DEMENTIA. Journal of Population Therapeutics and Clinical Pharmacology, 31(6), 2910-2919. https://doi.org/10.53555/jptcp.v31i6.7163