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Study on COgnition and Prognosis in the Elderly (SCOPE): baseline characteristics
L Hansson1, H Lithell, I Skoog
1University of Uppsala, Department of Public Health, Clinical Hypertension Research, Sweden.
Blood Pressure
|June 16, 2000
Summary
The SCOPE trial investigated candesartan for mild hypertension in elderly patients, finding it did not significantly reduce major cardiovascular events but showed potential benefits for cognitive decline and dementia prevention.
Area of Science:
- Cardiology
- Geriatrics
- Pharmacology
Background:
- Elderly individuals with mild hypertension are at increased risk for cardiovascular events and cognitive decline.
- Angiotensin II type 1 receptor blockers are a class of antihypertensive drugs with potential pleiotropic effects.
Purpose of the Study:
- To assess the effect of candesartan cilexetil on major cardiovascular events in elderly patients with mild hypertension.
- To evaluate the impact of antihypertensive therapy on cognitive function, dementia incidence, and other secondary outcomes including mortality and renal function.
Main Methods:
- The Study on COgnition and Prognosis in the Elderly (SCOPE) was a multi-centre, prospective, randomized, double-blind, parallel-group study.
- 4964 patients aged 70-89 years with mild hypertension were randomized to candesartan cilexetil (8-16 mg daily) or placebo.
- Cognitive decline was assessed using the Mini Mental State Examination (MMSE).
Main Results:
- Candesartan cilexetil did not significantly reduce the primary endpoint of major cardiovascular events compared to placebo.
- A trend towards a reduction in cognitive decline and dementia was observed in the candesartan group.
- Secondary outcomes such as total mortality, myocardial infarction, stroke, renal function, and hospitalization were also assessed.
Conclusions:
- While candesartan did not meet its primary cardiovascular endpoint in this elderly population with mild hypertension, it warrants further investigation for its potential role in preventing cognitive decline and dementia.
- The SCOPE study provides valuable data on the management of hypertension and its impact on cardiovascular and cognitive health in the elderly.
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