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Effects of different antihypertensive medication groups on cognitive function in older patients: A systematic review

Published online by Cambridge University Press:  23 March 2020

M. Stuhec ,
J. Keuschler ,
J. Serra-Mestres  and
M. Isetta
M. Stuhec*
Affiliation:
Department for clinical pharmacy, Ormoz psychiatric hospital, Ormoz, Slovenia Faculty of pharmacy, University of Ljubljana, Ljubljana, Slovenia
J. Keuschler
Affiliation:
Faculty of pharmacy, University of Ljubljana, Ljubljana, Slovenia
J. Serra-Mestres
Affiliation:
Central and North West London NHS Foundation Trust, London, UK
M. Isetta
Affiliation:
Central and North West London NHS Foundation Trust, London, UK
*
*Corresponding author at: Faculty of pharmacy, University of Ljubljana, Ljubljana, Slovenia. E-mail address:matejstuhec@gmail.com (M. Stuhec).
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Abstract

Background:

Chronic hypertension has been associated with an increased risk of cognitive decline. Although a link between hypertension and cognitive decline has been established, there is less evidence supported by systematic reviews. The main aim was to compare different antihypertensive drug groups in relation to their effect on cognition in older patients without established dementia using a systematic review.

Method:

A systematic search in Medline and Embase through to January 2017 was used to identify randomized controlled clinical trials (RCTs) studying the impact of different antihypertensives on cognition in older patients without dementia. Angiotensin II receptor blockers (ARBs), angiotensin-converting enzyme inhibitors (ACE-Is), beta-blockers (BBs), diuretics, and calcium channel blockers (CCBs) were included in this review.

Results:

The systematic search identified 358 studies. The full text of 31 RCTs was reviewed and a total of 15 RCTs were included in the review. Most studies reported an improvement in episodic memory in patients treated with ARBs versus placebo or other types of antihypertensive drugs. No study showed an improvement in cognition in patients who received diuretics, BBs, or CCBs. Heterogeneity was high in most trials (predominantly in the blinding of participants and investigators).

Conclusion:

This review suggests that ARBs can improve cognitive functions in the elderly, especially episodic memory. ACE-Is, diuretics, BBs and CCBs did not seem to improve cognitive function in the elderly but were similarly effective in blood pressure lowering as ARBs.

Keywords

Geriatric psychiatry and agingNeurologyPsychopharmacologyNeuroscienceCognition
Type
Review
Information
European Psychiatry , Volume 46 , October 2017 , pp. 1 - 15
Copyright
Copyright © European Psychiatric Association 2017

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