The Role of Ace Inhibitors in Maintaining Cognitive Function in Heart Failure Patients

Cardio-selective medications, including angiotensin-converting enzyme (ACE) inhibitors—both centrally and non-centrally active—and angiotensin receptor blockers (ARBs), may influence cognitive function in heart failure (HF) patients. This secondary analysis of a cross-sectional study involved 90 community-dwelling adults with HF, assessed for cognitive impairment using the Montreal Cognitive Assessment (MoCA). The mean MoCA score was 24.73 (SD = 2.76). T-tests indicated 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 showed higher ACE inhibitor dosages correlated with better cognitive function (r = 0.211, p = 0.046). In a multiple regression model adjusting for age, education, HF medication knowledge, and mean arterial blood pressure, ACE inhibitor use accounted for an additional 4.1% of the variance in cognitive scores and remained significant (p = 0.021). Age and blood pressure were not significant predictors. Findings suggest ACE inhibitors may exert protective cognitive effects in HF patients, warranting further investigation.