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Common Blood Pressure Drugs May Help Slow Dementia

Larger message: Better cardiovascular health benefits the brain, expert says

WebMD News from HealthDay

But the occurrence is rare, and alternatives

By Amy Norton

HealthDay Reporter

FRIDAY, July 26 (HealthDay News) -- Older adults with dementia who use certain blood pressure medications may have a slower rate of mental decline, new research suggests.

The study, reported July 25 in BMJ Open, found that dementia patients on particular ACE inhibitors showed a somewhat slower decline in memory and other mental skills than patients not on the drugs.

And dementia patients who were newly started on the drugs had, on average, a small improvement in the first six months.

The drugs linked to the benefit are known as centrally acting ACE inhibitors, which means they cross from the blood into the brain. They include commonly used medications such as captopril (Capoten), fosinopril (Monopril), lisinopril (Prinivil or Zestril), perindopril (Aceon), ramipril (Altace) and trandolapril (Mavik).

However, the findings do not mean that people with dementia should be started on those ACE inhibitors, according to a neurologist who was not involved with the research.

The study was not a clinical trial set up to test the effects of ACE inhibitors, noted Dr. Gayatri Devi, of Lenox Hill Hospital in New York City.

Instead, she said, it was an "observational" study, where researchers followed more than 350 older adults with Alzheimer's or other forms of dementia -- about one-quarter of whom happened to be on ACE inhibitors. Those types of studies cannot prove that a drug is the reason for a particular benefit.

"And there are past studies that have contradicted this one, and have not shown a benefit of ACE inhibitors," Devi said.

On the other hand, the findings support the "larger message" that better cardiovascular health -- including controlling blood pressure and cholesterol levels -- can benefit the brain as well, she said.

Previous studies have linked better blood pressure control -- and various classes of blood pressure drugs -- to both a lower risk of developing dementia and a slower progression of the disease. Currently, no treatments exist to prevent or modify dementia.

"The blood pressure medication that's best for you is the one that most effectively controls your blood pressure," Devi said. "People respond differently to the different classes of blood pressure drugs."

The study included 361 dementia patients, average age 77, who completed standard tests of memory, planning and other mental abilities. Of those, 85 were already on a centrally acting ACE inhibitor, and 30 more started on one during the study period.

On average, test scores declined by 1.8 points every six months among patients who were already on ACE inhibitors. That compared with 2.1 points for patients not on the drugs.

Among patients who newly started an ACE inhibitor, test scores typically rose 1.2 points in the first six months -- which was as long as that group was followed. The rest of the study patients were tracked for about a year-and-a-half.

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