| Autor: |
D'Silva E; Hatherly Laboratories, Institute of Biomedical and Clinical Sciences, Medical School, Faculty of Health and Life Sciences, Streatham Campus, University of Exeter, Exeter EX4 4PS, UK., Meor Azlan NF; Hatherly Laboratories, Institute of Biomedical and Clinical Sciences, Medical School, Faculty of Health and Life Sciences, Streatham Campus, University of Exeter, Exeter EX4 4PS, UK., Zhang J; Hatherly Laboratories, Institute of Biomedical and Clinical Sciences, Medical School, Faculty of Health and Life Sciences, Streatham Campus, University of Exeter, Exeter EX4 4PS, UK.; School of Medicine, Xiamen Cardiovascular Hospital of Xiamen University, Xiamen University, Xiang'an Nan Lu, Xiamen 361102, China.; State Key Laboratory of Bioorganic & Natural Products Chemistry, Research Center of Chemical Kinomics, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, # 345 Lingling Road, Shanghai 200032, China. |
| Abstrakt: |
Hypertension is a known risk factor for cognition-related pathologies including dementia. The National Institute of Health and Care Excellence (NICE) guidelines recommend angiotensin (Ang) II receptor blockers (ARBs) or angiotensin-converting enzyme inhibitors (ACEIs) as a first-line treatment for hypertension. Although both ARBs and ACEIs show neuroprotective effects, ACEIs show contradictory side effects; therefore, ARBs may be a more viable option. However, trials assessing the effects of ARBs on cognition are scarce and conflicting. Therefore, the aim of this review is to conduct a systematic review and synthesise data on the influence of ARBs on cognition and dementia prevention. Five databases were searched from 1992-2022 to produce 13 randomised controlled trials (RCTs) involving 26,907 patients that compared associations of ARBs against placebos or other antihypertensives on cognition or probable dementia with a minimum duration of 3 months. ARBs showed greater cognitive benefits when compared to hydrochlorothiazide (HCTZ), beta blockers (BB), and ACEIs. Our findings showed that although ARBs are superior to some antihypertensives such as ACEIs, thiazide and beta blockers, they made no difference in comparison to the placebo in all but one sample of patients. The positive effects on cognitive performances are equal to calcium channel blockers (CCBs) and lower than statin. The neuroprotective effects of ARBs are also more beneficial when ARBs are taken at the same time as a statin. Due to these inconsistencies, robust conclusions cannot be made. Future trials are warranted and, if successful, could have positive economic implications and consequently improve quality of life. |
