Share on Pinterest According to recent research, individuals with heart failure may experience a decreased risk of dementia with statin use. gece33/Getty ImagesPeople with cardiovascular disease, particularly heart failure, are at an elevated risk of developing dementia. Statins are a type of medication used to lower cholesterol and mitigate the risk of heart disease. A team from the University of Hong Kong has identified a potential link between statin use and a reduced risk of dementia among individuals with heart failure. Globally, over 500 million individuals have cardiovascular disease. Previous studies have indicated that people with cardiovascular disease, including heart failure, face an increased risk of dementia, including Alzheimer’s disease. Statins are a type of medication used to lower cholesterol levels and help prevent stroke and heart attack. Additionally, statins may be utilized in the prevention and treatment of heart failure. The researchers found that statins could potentially decrease the risk of dementia, including Alzheimer’s disease, among people with heart failure. The findings were recently published in the Lancet Regional Health journal. Prof. Kai-Hang Yiu, clinical professor in the Cardiology Division of the School of Clinical Medicine at the University of Hong Kong, Shenzhen Hospital, and Queen Mary Hospital, Hong Kong, China, explained to Medical News Today the rationale behind investigating the potential association between statin therapy and dementia incidence among heart failure patients. Prof. Yiu noted that previous research suggested that statins might have neuroprotective effects in addition to lowering cholesterol. “Non-cardiovascular outcomes are increasing among heart failure patients, especially dementia,” Prof. Yiu said, adding, “Therefore, it was important to investigate whether statin therapy could potentially reduce the risks of dementia incidence and its subtypes, including Alzheimer’s disease, vascular dementia, and unspecified dementia in patients with heart failure.” This is not the first study to explore the possible benefits of statins in reducing dementia risk. A study in December 2023 observed improved cognition over three years among individuals taking statins. Another study in February 2018 proposed that statins could play a therapeutic role in addressing neurotoxicity stemming from the protein beta-amyloid, which is considered to be a contributor to Alzheimer’s disease. For the current study, Prof. Yiu and team examined data from over 104,000 individuals with a primary diagnosis of heart failure within the Hong Kong Clinical Data Analysis and Reporting System database. Approximately 54,000 people used statins, and roughly 50,000 did not. Researchers investigated four types of statins individuals used, including: The researchers also assessed the risk of three types of dementia — Alzheimer’s disease, vascular dementia, and unspecified dementia. Upon analysis, the team reported that statin use was associated with a 20% lower risk of incident dementia compared to not using statins. Furthermore, statin use was linked to a 28% lower risk of Alzheimer’s disease, an 18% lower risk of vascular dementia, and a 20% lower risk of unspecified dementia. “I was to some extent surprised to find such a strong association between statin use and a lower risk of incident dementia in heart failure patients,” Prof. Yiu said. “While there has been some previous research suggesting that statins may have neuroprotective effects, the magnitude of the effect that we observed in our study was quite substantial.” The findings suggest that statin therapy may be beneficial in lowering the risk of multiple types of dementia among heart failure patients. Based on the current understanding of statins and their potential impact on dementia risk, Prof. Yiu highlighted several possible mechanisms that could explain their favorable effects. Firstly, he noted that statins are primarily used to lower cholesterol levels, and high cholesterol has been linked to an increased risk of dementia. “By reducing cholesterol levels, statins may help to prevent the buildup of plaques and tangles in the brain, which are characteristic features of Alzheimer’s disease,” Prof. Yiu added. Secondly, he pointed to the anti-inflammatory properties of statins. “Chronic inflammation is thought to play a role in the development of dementia,” he explained. “By reducing inflammation, statins may help to protect the brain from damage and neurodegeneration.” “Thirdly, statins have been shown to improve endothelial function, which is a significant risk factor for vascular dementia,” Prof. Yiu continued. “Finally, statins have been found to have antioxidant properties, which can help to reduce oxidative stress in the brain. Oxidative stress is known to contribute to the development of neurodegenerative diseases, including dementia.” “While these mechanisms offer a plausible explanation for the observed reduction in dementia risk associated with statin use, further research is needed to fully understand the exact mechanisms,” he added. Upon reviewing the study, Dr. Cheng-Han Chen, a board-certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, expressed surprise regarding the research results. “Statins are not traditionally indicated for heart failure specifically,” Dr. Chen explained. “We use statins for patients with high cholesterol and as secondary prevention in patients who have had cardiovascular conditions, but heart failure itself isn’t one of the conditions we typically associate with statins.” “So it was very impressive to see in this study that statins were able to reduce dementia incidents across the board,” he continued. “In particular, it was pretty impressive to see that it was able to reduce dementia in all subcategories, not just vascular dementia, which you would expect to have some sort of positive benefit.” Dr. José Morales, a vascular neurologist and neurointerventional surgeon at Pacific Neuroscience Institute in Santa Monica, CA, also commented on the study’s findings. Dr. Morales stated that these results are interesting and generally support the use of statins not only for protecting against vascular disease but potentially also for slowing the progression of dementia. “I do think that given the findings it would be worthwhile to replicate these results in different countries and among different ethnicities. Replicating these same findings in equally sized populations using statins and not using them and assessing the incidence of dementia could help us understand whether these observations apply broadly.” — Dr. José Morales, vascular neurologist and neurointerventional surgeon
