ConexiantTriple Cardiovascular Therapy Linked With Slower Cognitive Decline

Multi-cohort analysis of 4,651 older adults demonstrates potential neuroprotective benefits of combining antihypertensive, lipid-lowering, and antidiabetic medications. Study utilized longitudinal cognitive assessments with postmortem neuropathologic validation in 1,896 participants, providing robust evidence for cardiovascular-cognitive health connections.

⚕️ Key Clinical Considerations ⚕️

• Triple therapy associated with slower overall cognitive decline, particularly semantic and working memory preservation.
• Dual therapy showed benefits across episodic, semantic, and working memory domains with reduced AD pathology.
• Single-class therapy demonstrated more limited benefits, primarily in semantic memory and tangle reduction.
• Neuropathologic findings revealed reduced amyloid plaques, neurofibrillary tangles, and TDP-43 protein accumulation.
• Infarct risk paradox showed increased macroinfarct odds despite overall neuroprotective benefits.

🎯 Clinical Practice Impact 🎯

• Patient Communication: Counsel patients on potential cognitive benefits of comprehensive cardiovascular risk management beyond traditional endpoints.
• Practice Integration: Consider cognitive preservation as additional indication for optimizing multi-class cardiovascular therapy in appropriate candidates.
• Risk Management: Monitor for increased cerebrovascular events while pursuing multi-drug cardiovascular strategies, particularly in high-risk populations.
• Action Items: Reassess current prescribing patterns for patients with multiple cardiovascular risk factors to optimize potential neuroprotective benefits.

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