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Updated: Jan 7, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Correlation of cognitive functions of hypertensive patients on different classes of antihypertensive drugs
K Deepalakshmi1, S Vijayabaskaran1, K Subhiksha1
1Department of Physiology, PSG Institute of Medical Sciences and Research, Coimbatore, India *Email: drdeepalakshmik@gmail.com.
Insights
Hypertension is linked to cognitive decline. Angiotensin Receptor Blockers (ARBs) show a protective effect on cognition compared to other antihypertensive drugs, suggesting their importance in managing cognitive health in hypertensive patients.
Area of Science:
- Neurology
- Cardiology
- Pharmacology
Background:
- Cognitive impairment is a significant global health issue.
- Hypertension, advanced age, and stroke are key risk factors for cognitive decline.
- Elderly individuals with hypertension experience accelerated cognitive decline, which can be mitigated by antihypertensive treatment.
Purpose of the Study:
- To compare cognitive scores among hypertensive individuals using different classes of antihypertensive drugs.
- To investigate the correlation between blood pressure levels and cognitive function in hypertensive patients.
Main Methods:
- A single-center, cross-sectional study involving 249 hypertensive individuals aged 35-60 years.
- Cognitive function assessed using the Montreal Cognitive Assessment (MoCA) test (normal score ≥ 26).
- Participants categorized into groups based on antihypertensive medication: Angiotensin Receptor Blockers (ARBs), Calcium Channel Blockers (CCBs), and others.
Main Results:
- Patients on ARBs demonstrated higher cognitive scores (25.1 ± 3) compared to those on CCBs (22.6 ± 3.8) and other antihypertensives (24.3 ± 3.8).
- A negative association was observed between cognitive scores and mean arterial pressure (P-value = 0.45).
- Hypertensive individuals with over 5 years of hypertension and irregular treatment showed significantly lower cognitive scores.
Conclusions:
- A strong association exists between hypertension and cognitive function decline.
- Angiotensin Receptor Blockers (ARBs) appear to have a protective effect on cognition compared to other antihypertensive drug classes.
- Pharmacodynamics of antihypertensive medications should be considered for preserving cognitive health in hypertensive populations.
Background:
Globally, cognitive impairment has evolved as a major health and social issue. Hypertension, age, and stroke are independent risk factors for the development of cognitive impairment. Elderly individuals with hypertension are more prone to earlier cognitive decline. The risk is reduced by proper antihypertensive treatment. Various classes of antihypertensive drugs have varied protective effects on cognition, so we aimed to compare the cognitive scores of individuals taking different classes of antihypertensive drugs and correlate the blood pressure levels with their cognitive scores.
Methods:
Known hypertensive individuals belonging to the age group of 35 to 60 years participated in this single-center cross-sectional study conducted in a tertiary care center in southern India. Individuals with any chronic systemic illness or any history of pre-existing cognitive impairment were excluded from the study. After taking a detailed history on hypertension and drug history, the patient's cognition was assessed using the Montreal Cognitive Assessment (MoCA) test. Out of a total score of 30, greater than or equal to 26 is considered normal. The hypertensive individuals were divided into three groups, namely those who were taking Angiotensin Receptor Blockers (ARBs), Calcium Channel Blockers (CCBs), and other antihypertensive drugs, and their cognitive scores were compared.
Results:
Two hundred and forty-nine known hypertensive individuals participated in the study, of whom 43% were found to be males. Patients on ARBs (25.1 ± 3) had higher cognitive scores compared to CCBs (22.6 ± 3.8) and other antihypertensive drugs (24.3 ± 3.8). When the cognitive scores were correlated with mean arterial pressure, it showed a negative association was shown (P-value, 0.45). When grouped individually and analyzed using an independent t-test, patients who have been hypertensive for more than 5 years and who were on irregular treatment showed lower cognitive scores, which is statistically significant.
Conclusion:
Our study showed a strong association between hypertension and cognitive function decline, and also the ARBs' protective effect over other classes of antihypertensive drugs. The pharmacodynamics of different classes of antihypertensive drugs should be taken into account to support the cognitive health of hypertensive individuals.
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