Class of Blood Pressure Lowering Drugs Associated with Slowing of Cognitive Decline

Could the medication you are taking for high blood pressure also help to prevent cognitive decline? A piece of research carried out by teams in Ireland and Canada, which was published in BMJ Open, has found that centrally acting ACE inhibitors (CACE-Is), which are prescribed to help lower blood pressure, resulted in a slight slowing in the rate at which cognitive decline occurred over a six month period. The study also identified an improvement in mental function during the first six months of being started on this treatment.

Class of Blood Pressure Lowering Drugs Associated with Slowing of Cognitive Decline
Class of Blood Pressure Lowering Drugs Associated with Slowing of Cognitive Decline

The Study
Information relating to 1749 patients attending a Canadian memory clinic, covering a ten year period, was collected for the work, which included scores on two tests used to assess mental ability; each test had been performed twice, six months apart. The study included 817 participants with a diagnosis of one of the three main types of dementia. However, after screening for suitability, data from only 361 people was able to be used for analysis; 85 were taking CACE-Is and of these 30 were within the first six months of treatment. This type of ACE inhibitor differs from others, as they cross the barrier into the brain and therefore can have a positive impact upon its blood flow and blood pressure, which previous research has indicated as beneficial to cognition.

The Findings and conclusions

Statistically significant differences were found with the improvement in the mental ability scores for one of the tests between patients taking CACE-Is and those who weren’t, and that the improvements were greatest for those new to the drugs. However, before drawing conclusions regarding a direct benefit, it is important to be mindful of a number of factors:


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  • This was a small study conducted over a short time frame, so it is uncertain whether the small slowing of cognitive decline seen amongst participants would have consequences for the longer term picture.
  • The study merely shows an association between the two factors and does not prove that this medication directly benefits mental ability.
  • Reduced blood pressure itself is beneficial for cognitive function and it may be this rather than the action of the drugs themselves that are producing the improvement.
  • This class of drugs is not suitable for everyone due to the potential side effects.

Further research is therefore needed to determine whether this class of drugs is of true benefit to those with dementia and who would gain the most from this treatment.