According to new research published today in the American Heart Association, older adults taking blood pressure-lowering drugs known to cross the blood-brain barrier remembered memory better than those taking other types of medications to treat high blood pressure. . Hypertension.
High blood pressure, or hypertension, is a risk factor cognitive decline and dementia older adults. Nearly half of American adults have high blood pressure. Treatment high blood pressure with drugs that lower blood pressure reduced cases of mild cognitive impairment by 19% in a large trial (SPRINT MIND).
ACE inhibitors, angiotensin II receiver blockers (ARB), calcium channel blockers and diuretics are different kinds of medications to lower blood pressure. Each class acts differently to lower blood pressure and some cross the blood-brain barrier, thus affecting cognitive function.
“Research has been mixed on which drugs have the most benefits for cognition,” said study author Daniel A. Nation, Ph.D., an associate professor of psychological sciences at the Institute for Cognitive Sciences. memory impairments and neurological disorders at the University of California, Irvine. “Studies on angiotensin II receptor blockers and angiotensin converting enzyme (ACE) inhibitors have suggested that these drugs may confer the greatest benefit to long-term cognition, while other studies have shown the benefits of calcium channel blockers and diuretics to reduce the risk of dementia “.
This is the first meta-analysis comparing the potential impact over time of drugs that lower blood pressure and those that do not cross the blood-brain barrier. Medications were evaluated for their effects in several cognitive domains, including attention, language, verbal memory, learning, and memory.
“Hypertension occurs decades before the onset of dementia symptoms, which affect blood flow not only to the body but also to the brain,” Nation said. “The treatment of hypertension is likely to have long-term beneficial effects on brain health and cognitive function later on.”
The researchers collected information from 14 studies of about 12,900 adults aged 50 or older. These included studies done in the United States, Australia, Canada, Germany, Ireland, and Japan. The meta-analysis found:
- Older adults taking blood pressure-lowering drugs that crossed the blood-brain barrier had a better memory record for up to 3 years of follow-up compared with those taking drugs that did not cross the blood-brain barrier even though they had a higher level. other vascular risk.
- Adults taking antihypertensive drugs that did not cross the blood-brain barrier had better care during a follow-up of up to 3 years.
“These findings represent the most powerful evidence to date that links brain-penetrating ACE inhibitors and angiotensin receptor blockers with better memory. It suggests that people who are being treated for hypertension may be protected against cognitive impairment if they have drugs that cross their blood. brain barrier, “said study co-author Jean K. Ho, Ph.D., a postdoctoral fellow at the University of California, Irvine.
Blood pressure is considered to be elevated to 120/80 mm Hg and above. The current Guidelines of the American Heart Association / American College of Cardiology for the treatment of high blood pressure, changes in diet and activity levels are suggested to lower blood pressure and add medications to lower blood pressure for people with levels of 130/80 mm Hg or higher depending on the your risk status. If blood pressure reaches 140/90 mm Hg, a medication to lower blood pressure is recommended.
The limitations of this analysis are that the authors could not explain the differences in racial /ethnic background according to available studies, and there is a higher proportion of men and women in the group who took medications that crossed the blood-brain barrier. This is an important area of future research, as previous studies have shown that people from diverse ethnic or racial backgrounds may respond differently to blood pressure medications.
Hypertension (2021). DOI: 10.1161 / HYPERTENSIONAHA.121.17049
American Heart Association
Citation: Some Medications to Lower Blood Pressure Related to Decreased Memory in Older Adults (2021, June 21) Retrieved June 21, 2021 at https://medicalxpress.com/news/2021-06-blood-pressure -lowering-meds-linked- memory.html
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