Influence of losartan and atenolol on cognitive function in very elderly hypertensive patients

The aim of the study was to compare the effect of losartan and atenolol on cognitive function in very elderly hypertensive patients. Forty-two mild to moderate hypertensive (SBP >160 < 200 mmHg; DBP > 90 < 105 mmHg) patients aged 75-89 years were studied. After a 4 week placebo period they were randomized to losartan 50 mg or to atenolol 50 mg for 12 weeks; then after a 4 week intermediate placebo period they were crossed to the alternative treatment according to a double blind cross-over design. At the end of the placebo period and of each active treatment period BP was measured and cognitive functions were evaluated through 3 different tests (word list memory, word list recall and word list fluency). The main results are shown in the table. p < 0.05; p < 0.01 vs placebo In conclusion both atenolol and losartan were equally effective in lowering BP; losartan induced a significant improvement in one of the 3 tests for cognitive function and a trend to improve in the others. Atenolol did not induce any significant change in any test, however always showed a trend to worse. These data suggest that in elderly hypertensive At 1 receptor blockade could improve some important aspects of quality of life, in particular the memory recall.