Some ACE Inhibitors Slow Dementia Decline While Others Speed It Along
July 26th 2009 20:55
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The typical first line treatment for hypertension, ACE Inhibitors, may also help prevent dementia. This new research buttresses a study published in 2007 by the same group at Wake Forest University School of Medicine.
Dr. Kaycee Sink, M.D. M.A.S. and her colleagues found that those ACE inhibitors that pass through the blood/brain barrier are the ones that reduce the risk of dementia. The other ACE inhibitors and hypertension drugs had no beneficial affect. The researchers believe there is a relationship between hypertension (high blood pressure) and dementia.
The drugs that passed through the brain/blood barrier are called centrally-active ACE inhibitors. They include lisinopril (Prinivil® or Zestri®), captropril (Capoten®), perindopril (Aceon®), fosinopril (Monopril®), ramipril (Altace®) and trandolapril (Mavik®).
There was a benefit to those who took the centrally active drugs. Sing and her colleagues measured lower rates of mental decline using the Modified Mini-Mental State Exam, a test that evaluates memory, language, abstract reasoning and other cognitive functions. On average those participants saw an average 65 percent less cognitive decline per year of exposure compared to participants taking other blood pressure medications.
Sing, geriatrician and an assistant professor of internal medicine – gerontology, says that hypertension is an “important risk factor” for Alzheimer’s disease and vascular dementia. “Our study found that all blood pressure medications may not be equal when it comes to reducing the risk of dementia in patients with hypertension.”
Taking the wrong kind of Ace inhibitor could increase the risk for dementia. Sing found that those taking non-centrally active ACE inhibitors were more likely to develop difficulty performing daily activities. They were at a 73 percent increased risk for the disease when compared to participants taking other anti-hypertensive drugs.
This study involved data from the Cardiovascular Health Study, a long-term study of cardiovascular risk factors that involved 5,888 people over 65 years old from Forsyth County, N.C.; Sacramento County, Calif.; Pittsburgh, Pa.; and Washington County, Md. The study involved 1,074 participants who were free of dementia when they entered the study and who were being treated for hypertension.
Ace inhibitors - for and against dementia - click here for the link
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