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Blood Pressure Drug May Slow Cognitive Decline

Recently published studies suggest that antihypertensive agents, particularly centrally acting ACE inhibitors (CACE-Is) such as angiotensin-converting enzyme (ACE) inhibitors, which cross the blood-brain barrier, may be associated with a reduced rate of cognitive decline. William Molloy, from the University College Cork, St. Finbarrs’ Hospital (Ireland), and colleagues  compared the rates of cognitive decline in 361 subjects, average age 77 years, who had been diagnosed with Alzheimer’s disease, vascular dementia, or a mix of both conditions.  Between 1999 and 2010, the cognitive decline of each patient was assessed using standardized scales on two separate occasions, 6 months apart.  A total of 85 of the patients were already taking ACE inhibitors; the rest were not.  The researchers also assessed the first 6 months’ impact of ACE inhibitors on cognitive function of 30 patients newly prescribed ACE inhibitors.  The team observed that the subjects taking centrally active ACE inhibitors experienced marginally slower rates of cognitive decline compared with those not on the drugs (drop of 1.8 points versus 2.12 points on the Quick Mild Cognitive Impairment scores).  The study authors conclude that: “Cognitive scores may improve in the first 6 months after CACE-I treatment and use of CACE-Is is associated with a reduced rate of cognitive decline in patients with dementia.”

Gao Y, O'Caoimh R, Healy L, Kerins DM, Eustace J, Guyatt G, Sammon D, Molloy DW. “Effects of centrally acting ACE inhibitors on the rate of cognitive decline in dementia.”  BMJ Open. 2013 Jul 25;3(7).

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