How Existing Cardiovascular Drugs Could Slow Cognitive Decline

Are cheap medications that may prevent Alzheimer’s disease already on the market? At the 2025 Alzheimer’s Association International Conference (AAIC) in Toronto, Dr. Roshni Biswas of the Rush Alzheimer’s Disease Center in Chicago presented data that showed that people who took existing drugs that treat multiple cardiovascular risk factors had slower cognitive decline than those who didn’t take any medications, as well as fewer Alzheimer’s plaques in the brain. 

According to the data, using existing drugs on the market to control readily treatable cardiovascular risk factors, such as high blood pressure, diabetes, and high cholesterol, may reduce the risk of developing the disease. People taking two or three different types of medication to treat these risk factors had a slower rate of cognitive decline compared to those who weren’t taking any medications, Biswas said.

The brain benefits of cardiovascular drugs

Biswas and her colleagues examined the medical records of 4,651 older adults, who were on average 77 years old, from five different longitudinal studies of brain aging. 

The team counted the number of different classes of medications — blood pressure-lowering drugs, cholesterol-lowering drugs, and diabetes drugs — that participants were taking at the start of the study. (For example, someone taking medications to treat blood pressure and cholesterol, but not diabetes, would be counted as taking two classes of drugs. However, if someone was taking two different types of blood pressure medications, but nothing for diabetes or cholesterol, they would still be taking one.) The total number of drugs, dosages, and how they change over time was not factored into the analysis. About 75 percent of the participants were taking at least one of these drugs at baseline. 

What the team found was that compared to older adults who weren’t taking any of these existing cardiovascular medications, those taking three classes of drugs had a slower rate of cognitive decline over time. They also had lower levels of shrinkage of the brain’s memory region, and lower levels of Alzheimer’s pathology post-mortem, like the levels of amyloid plaques, tau tangles, and other protein plaques in the brain. (As many as 30 percent of older adults might have plaques and tangles in their brain, but never develop cognitive symptoms.)

They also found that taking two types of medications was also linked to a slower cognitive decline and less brain pathology, but the effect wasn’t as strong. Taking just one class of medication was linked to even fewer benefits.

The researchers saw that 90 percent of people would take at least one of these drugs at some point during the study, but they didn’t have data on the specific doses people were taking, or how dosing changed over time. They also didn’t have data on how many of the participants were actually diagnosed with Alzheimer’s.

“Our findings really suggest that early intervention using a combination approach targeting these risk factors is more effective than a single-target approach in reducing dementia risk,” Biswas told Being Patient. This is significant because it signals to researchers that they need to be testing multiple different types of drugs in combination to see if they can prevent dementia, rather than measuring the effects one at a time.

Promising data, with caveats

While older adults should speak with their healthcare providers to find out if they have any cardiovascular risk factors that put them at risk, the study does not suggest people should take these medications if their blood pressure, cholesterol, and blood glucose are at healthy levels. 

Still, Maria Glymour, an epidemiologist at Boston University who wasn’t involved in the research, told Being Patient that “repurposing existing medications is among the most promising avenues [for treating dementia], especially when evaluating medications for very common chronic conditions, such as hypertension and diabetes.”  

By examining brain pathology, Glymour said, researchers can avoid some of the tricky, hard-to-control biases that arise when scientists investigate whether existing drugs might prevent dementia. For example, in observational studies, it is challenging to account for all other potential factors that could lead to dementia, such as socioeconomic status or other health conditions. It’s also hard to tell whether the drug reduces the risk of a disease, or the people taking the drug are simply being more proactive about their health, and might be more likely to engage in exercise, a healthy diet, or other activities that modify the risk of the disease.

Since “this is not a randomized clinical trial,” said Biswas, “there could be underlying differences: for example, adherence to medication. That could lead to potential biases in our results.” 

While the results are positive, Biswas cautioned that the study was observational. More research is needed to definitively prove that a combination of drugs that treat underlying cardiovascular disease could slow cognitive decline or prevent Alzheimer’s.

But some researchers are already taking the next step, conducting gold-standard trials to study these classes of drugs. Danish healthcare giant Novo Nordisk’s blockbuster weight loss and diabetes drugs, Wegovy and Ozempic, are in a large Phase 3 trial for Alzheimer’s disease, set to finish later this year. Plus, a recent trial in China found that blood pressure medications could reduce the risk of dementia by 15 percent.

For now, an overwhelming amount of research shows what’s good for the heart is also good for the brain. If your doctor suggests going on medications to reduce the risk of cardiovascular disease, you might also be protecting against dementia.