Key result
Twenty-four weeks of hypotensive treatment with ACE inhibitors or diuretics increased regional cerebral blood flow by 7-11% and improved cognitive function, including attention and psychomotor speed, by 10-18% in patients with arterial hypertension.
Why the study?
Does hypotensive therapy improve brain perfusion and cognitive function in patients with essential hypertension?
Observational (n=26)
No
Does hypotensive therapy improve brain perfusion and cognitive function in patients with essential hypertension?
Hypotensive therapy with ACE inhibitors or diuretics significantly improves cerebral perfusion and cognitive function in patients with essential hypertension.
May support cognitive benefits from ACEi/diuretics in hypertension; leaves open causal confirmation in randomized trials.
The aim of our study was to estimate brain perfusion and cognitive function (CF) in patients with arterial hypertension (AH) before and after hypotensive therapy. The study included 15 patients (mean age, 53.0+/-5.7 years) with previously untreated or ineffectively treated essential hypertension of the second degree. All patients underwent brain single photon emission computed tomography (SPECT) scanning with 99mTc-hexamethylpropylene amine oxime (99mTc-HMPAO) and comprehensive neuropsychological testing before and after 24 weeks of hypotensive therapy (angiotensin-converting enzyme [ACE] inhibitor or diuretics). The brain perfusion was significantly lower (15-22%) in all regions of AH patients. These patients showed a 25% decrease in attention and psychomotor speed as well as a 14% decrease in mentation. Six months of hypotensive therapy led to an increase in brain perfusion by an average of 7-11% in all brain regions. After treatment these patients demonstrated an average 11-18% improvements in attention and psychomotor speed, as well as an average 10% improvement in abstract mentation. Marked signs of brain hypoperfusion and impaired CF: decrease in attention, slowing psychomotor speed and mentation was found in hypertensive patients even without focal neurological symptomatology. Twenty-four weeks of hypotensive treatment with ACE inhibitors or diuretics had a positive effect on cerebral perfusion and led to CF improvement.
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Ефимова et al. (2008) conducted an observational in Arterial hypertension (n=26). Hypotensive therapy (enalapril or indapamide-retard) vs. Baseline (pre-treatment) was evaluated on Regional cerebral blood flow (rCBF) and cognitive function. Twenty-four weeks of hypotensive treatment with ACE inhibitors or diuretics increased regional cerebral blood flow by 7-11% and improved cognitive function, including attention and psychomotor speed, by 10-18% in patients with arterial hypertension.
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