We appreciate the comments by Dr. Kalra and agree that studies with prior hypotheses have higher credibility. However, data from this large-scale trial of a well-defined, nationally representative cohort offer an opportunity to apply methods to study novel risk factors that would be less feasible with smaller samples.
The issue of multiple comparisons was addressed by setting a stricter p-value of less than 0.01 The lack of significant findings among participants with mild cognitive impairment can be explained by sample size of this group (N=320, 110 developed AD) compared to the normal group (N=1928, 180 developed AD). Regarding blood pressure assessment, blood pressure was measured at each visit[1] Within the limits of secondary data analysis, our results support the possibility of beneficial effects of antihypertensive medications in addition to the blood pressure-lowering effect on the risk of AD. Our study confirms existing data, such as the study by Godin et al. [2], which examined white matter disease progression in participants with normal cognition and found no significant difference in baseline WML load and WML progression among participants treated with antihypertensive medications independent of blood pressure control.
We believe that antihypertensive medications can exert multiple beneficial effects on AD risk reduction.
For disclosures, please contact the editorial office at journal@neurology.org.
We appreciate the comments by Dr. Kalra and agree that studies with prior hypotheses have higher credibility. However, data from this large-scale trial of a well-defined, nationally representative cohort offer an opportunity to apply methods to study novel risk factors that would be less feasible with smaller samples.
The issue of multiple comparisons was addressed by setting a stricter p-value of less than 0.01 The lack of significant findings among participants with mild cognitive impairment can be explained by sample size of this group (N=320, 110 developed AD) compared to the normal group (N=1928, 180 developed AD). Regarding blood pressure assessment, blood pressure was measured at each visit[1] Within the limits of secondary data analysis, our results support the possibility of beneficial effects of antihypertensive medications in addition to the blood pressure-lowering effect on the risk of AD. Our study confirms existing data, such as the study by Godin et al. [2], which examined white matter disease progression in participants with normal cognition and found no significant difference in baseline WML load and WML progression among participants treated with antihypertensive medications independent of blood pressure control.
We believe that antihypertensive medications can exert multiple beneficial effects on AD risk reduction.
For disclosures, please contact the editorial office at journal@neurology.org.