Modulating Cognitive Function with Antihypertensive Medications: a Comprehensive Systematic Review On FMRI Studies

Area of Science:

• Neuroscience
• Cardiovascular Medicine
• Pharmacology

Background:

• Hypertension (HTN) is a common cardiovascular disease linked to cognitive deficits, including memory and attention problems.
• Understanding the neural basis of HTN-related cognitive dysfunction is vital for developing effective treatments.

Purpose of the Study:

• To systematically review the effects of antihypertensive medications on cognitive functions, specifically memory, attention, and emotion processing.
• To investigate the neural mechanisms underlying these cognitive effects using functional magnetic resonance imaging (fMRI).

Main Methods:

• A systematic literature search was conducted in PubMed and Scopus up to March 10, 2024.
• Included studies focused on antihypertensive drugs and their impact on cognition, analyzed via fMRI.
• 12 systematic reviews and meta-analyses were selected from 108 identified articles.

Main Results:

• Losartan enhanced negative memory encoding and fear extinction, modulating hippocampal and prefrontal activity.
• Propranolol impaired fear reconsolidation and emotional memory retrieval, affecting the amygdala and hippocampus.
• Spironolactone mitigated stress-induced memory alterations in the amygdala, showing distinct drug-specific neural effects.

Conclusions:

• Antihypertensive medications, including losartan and propranolol, show promise in modulating memory and fear-related processes.
• These findings suggest therapeutic potential for conditions like PTSD and anxiety disorders.
• fMRI is crucial for understanding HTN-related cognitive impairments and guiding treatment optimization.