Key result
Angiotensin II receptor blockers (ARBs) improved episodic memory in older patients without dementia compared to placebo or other antihypertensives, whereas other classes did not.
Why the study?
Do different classes of antihypertensive medications improve cognitive function in older patients without established dementia?
Systematic Review (n=15)
Do different classes of antihypertensive medications improve cognitive function in older patients without established dementia?
ARBs may offer a specific advantage in improving episodic memory in older patients without dementia compared to other antihypertensive classes.
Positions ARBs as a potentially preferred antihypertensive for cognitive preservation; extends their.
BACKGROUND: Chronic hypertension has been associated with an increased risk of cognitive decline. Although a link between hypertension and cognitive decline has been established, there is less evidence supported by systematic reviews. The main aim was to compare different antihypertensive drug groups in relation to their effect on cognition in older patients without established dementia using a systematic review. METHOD: A systematic search in Medline and Embase through to January 2017 was used to identify randomized controlled clinical trials (RCTs) studying the impact of different antihypertensives on cognition in older patients without dementia. Angiotensin II receptor blockers (ARBs), angiotensin-converting enzyme inhibitors (ACE-Is), beta-blockers (BBs), diuretics, and calcium channel blockers (CCBs) were included in this review. RESULTS: The systematic search identified 358 studies. The full text of 31 RCTs was reviewed and a total of 15 RCTs were included in the review. Most studies reported an improvement in episodic memory in patients treated with ARBs versus placebo or other types of antihypertensive drugs. No study showed an improvement in cognition in patients who received diuretics, BBs, or CCBs. Heterogeneity was high in most trials (predominantly in the blinding of participants and investigators). CONCLUSION: This review suggests that ARBs can improve cognitive functions in the elderly, especially episodic memory. ACE-Is, diuretics, BBs and CCBs did not seem to improve cognitive function in the elderly but were similarly effective in blood pressure lowering as ARBs.
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Štuhec et al. (2017) conducted a systematic review in Cognitive decline in older patients with hypertension (n=15). Antihypertensive drugs (ARBs, ACE-Is, BBs, diuretics, CCBs) vs. Placebo or other types of antihypertensive drugs was evaluated on Cognitive function (episodic memory). Angiotensin II receptor blockers (ARBs) improved episodic memory in older patients without dementia compared to placebo or other antihypertensives, whereas other classes did not.
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