Why the study?
Do ARBs and ACE inhibitors prevent vascular dementia in elderly patients with hypertension?
Do ARBs and ACE inhibitors prevent vascular dementia in elderly patients with hypertension?
Angiotensin receptor blockers may offer superior neuroprotection beyond blood pressure reduction and should be strongly considered as first-line therapy for hypertension and cognitive protection in the elderly.
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May support ARB preference for cognitive protection in elderly hypertension; hypothesis-generating and requires randomized confirmation.
Hypertension is a leading risk factor for vascular dementia. With the increasing burden of dementia, prevention and delay of cognitive decline are becoming a priority. Recent clinical trials have demonstrated that patients taking antihypertensive medications have a reduced incidence of dementia and cognitive impairment. Calcium channel blockers, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers appear to offer significant neuroprotection, even beyond blood pressure reduction. Evidence is emerging that the angiotensin receptor blockers offer superior neuroprotection. This finding has been attributed to the unique property of sustained blockade of the AT1 receptor, combined with simultaneous activation of the AT2 receptors. The use of angiotensin receptor blockers as first-line therapy for hypertension and cognitive protection in the elderly should be strongly considered.
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Donna S. Hanes (2007) studied this question.
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