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Cardiovascular Effects of Drugs Used to Treat Alzheimer’s Disease

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Abstract

Drugs that are used to treat Alzheimer’s disease include the acetyl cholinesterase inhibitors (ACHIs) donepezil, rivastigmine and galantamine and the NMDA receptor antagonist memantine. Adverse cardiovascular events with these drugs are very uncommon. However, there is evidence that ACHI therapy is associated with a small but significant increase in the risk of syncope and bradycardia. There are also a few reports that these drugs may occasionally be associated with QT prolongation and torsades de pointes ventricular tachycardia. Adverse cardiovascular effects of ACHIs including syncope and bradycardia are less common than their adverse gastrointestinal effects, but they remain important considerations in susceptible individuals. In contrast, animal studies and some observational studies suggest that ACHIs may reduce myocardial infarction and cardiovascular mortality and have favourable effects on hemodynamics and survival in heart failure. Further research is required to confirm these potential beneficial effects. Little is known about the cardiovascular effects of memantine but there have been reports of bradycardia and reduced cardiovascular survival associated with its use.

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Funding and conflicts of interest

No funding was received for the preparation of this manuscript. Laurence Guy Howes has been a sub-investigator in two clinical trials of a new drug for Alzheimer’s disease funded by Servier Pty Ltd. He has no other conflicts of interest that are directly relevant to the content of this review.

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  1. Department of Cardiology, Gold Coast University Hospital, Griffith University School of Medicine, Southport, QLD, 2015, Australia

    Laurence Guy Howes

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  1. Laurence Guy Howes
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Correspondence to Laurence Guy Howes.

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Howes, L.G. Cardiovascular Effects of Drugs Used to Treat Alzheimer’s Disease. Drug Saf 37, 391–395 (2014). https://doi.org/10.1007/s40264-014-0161-z

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