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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Influence of losartan and atenolol on memory function in very elderly hypertensive patients

R Fogari1, A Mugellini, A Zoppi

  • 1Department of Internal Medicine and Therapeutics, Clinica Medica II, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy. r.fogari@smatteo.pv.it

Journal of Human Hypertension
|October 28, 2003
PubMed

Insights

Losartan, an Angiotensin II type 1 receptor antagonist, improved memory in elderly hypertensive patients. Atenolol, a beta-blocker, did not significantly affect cognitive function in this group.

Area of Science:

  • Gerontology
  • Cardiology
  • Pharmacology

Background:

  • Hypertension is prevalent in the elderly, increasing risk for cognitive decline.
  • Beta-adrenergic blockers and Angiotensin II type 1 receptor antagonists are common antihypertensive treatments.
  • The impact of these medications on cognitive function in very elderly individuals requires further investigation.

Purpose of the Study:

  • To compare the effects of atenolol and losartan on cognitive function in very elderly hypertensive patients.
  • To assess the efficacy of these drugs in improving cognitive performance in this demographic.

Main Methods:

  • 120 hypertensive patients aged 75-89 years were randomized to receive atenolol or losartan for 24 weeks after a placebo wash-out.
  • Blood pressure was measured, and cognitive function was evaluated using word list memory, recall, and fluency tests.
  • A parallel arm design was employed for the study.

Main Results:

  • Both atenolol and losartan effectively reduced systolic and diastolic blood pressure.
  • Losartan significantly improved scores in word list memory and word list recall tests.
  • Atenolol did not induce significant changes in cognitive test scores compared to baseline.

Conclusions:

  • Chronic AT1 receptor blockade with losartan may enhance cognitive function, particularly memory, in very elderly hypertensive patients.
  • Losartan demonstrated a significant advantage over atenolol in improving memory-related cognitive tests.
  • These findings suggest a potential role for losartan in mitigating cognitive decline associated with hypertension in older adults.

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