Cardio-selective medications, including angiotensin-converting enzyme (ACE) inhibitors—both centrally active and non-centrally active—and angiotensin receptor blockers (ARBs), have been investigated for cognitive benefits in heart failure (HF) patients. This secondary analysis of a cross-sectional study involved 90 community-dwelling adults with HF screened for cognitive impairment using the Montreal Cognitive Assessment (MoCA), with a mean score of 24.73 (SD = 2.76). T-tests revealed a significant association between ACE inhibitor use (78% of participants) and MoCA scores (p = 0.01), particularly for centrally active ACE inhibitors (60%), while no association was observed with ARB use. Bivariate analysis indicated that higher ACE inhibitor dosages correlated with improved cognitive function (r = 0.211, p = 0.046). In a multiple regression model adjusting for age, education, heart failure medication knowledge, and mean arterial blood pressure, ACE inhibitor use contributed an additional 4.1% to the explained variance in cognitive function and remained statistically significant (p = 0.021). Age and mean arterial blood pressure were not significant in the final model. These findings suggest a protective cognitive effect of ACE inhibitors in HF patients and support further investigation into their potential role in mitigating cognitive decline.
Sarah E. Montgomery (2025) studied this question.