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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
07:30

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Published on: April 23, 2021

Effects of valsartan compared with enalapril on blood pressure and cognitive function in elderly patients with

Roberto Fogari1, Amedeo Mugellini, Annalisa Zoppi

  • 1Department of Internal Medicine and Therapeutics, Centro Ipertensione e Fisiopatologia Cardiovascolare, Clinica Medica II, IRCCS Policlinico S. Matteo, University of Pavia, Piazzale Golgi 2, 27100, Pavia, Italy. r.fogari@smatteo.pv.it

European Journal of Clinical Pharmacology
|January 30, 2004
PubMed

Insights

Valsartan more effectively lowers blood pressure (BP) in elderly patients with hypertension than enalapril. Unlike enalapril, valsartan also significantly improved memory functions.

Area of Science:

  • Cardiology
  • Geriatrics
  • Pharmacology

Background:

  • Essential hypertension is a prevalent condition in elderly individuals, increasing the risk of cardiovascular and cognitive decline.
  • Angiotensin II (Ang II) AT1 receptor antagonists and ACE inhibitors are common antihypertensive drug classes with distinct mechanisms of action.
  • The impact of these medications on cognitive function in older adults warrants further investigation.

Purpose of the Study:

  • To compare the efficacy of valsartan (Ang II AT1 receptor antagonist) versus enalapril (ACE inhibitor) in managing blood pressure (BP) in elderly hypertensive patients.
  • To assess the effects of valsartan and enalapril on cognitive functions in this patient population.

Main Methods:

  • A prospective, randomized, open-label, blinded-endpoint study involving 144 elderly hypertensive patients (aged 61-80 years).
  • Patients received either valsartan 160 mg once daily or enalapril 20 mg once daily for 16 weeks.
  • Blood pressure was measured regularly, and cognitive function was evaluated using five standardized tests at baseline and after 16 weeks.

Main Results:

  • Both valsartan and enalapril demonstrated significant antihypertensive effects.
  • Valsartan achieved a statistically greater reduction in systolic and diastolic blood pressure compared to enalapril (P<0.01).
  • Valsartan significantly improved word list memory and recall scores (+11.8% and +18.7%, respectively; P<0.05), while enalapril did not significantly alter cognitive test scores.

Conclusions:

  • Valsartan (160 mg once daily) is more effective than enalapril (20 mg once daily) in reducing blood pressure in elderly hypertensive patients.
  • Valsartan treatment, unlike enalapril, showed significant improvements in specific cognitive functions, particularly episodic memory.
  • These findings suggest potential benefits of valsartan beyond BP control in older adults with hypertension.
Abstract

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