I had to look up mine separately; nifediprine, is in a class of medications called calcium-channel blockers
- Azilsartan (Edarbi)
- Candesartan (Atacand)
- Eprosartan.
- Irbesartan (Avapro)
- Losartan (Cozaar)
- Olmesartan (Benicar)
- Telmisartan (Micardis)
- Valsartan (Diovan)
Angiotensin receptor blockers may lower risk for progression to dementia
Angiotensin receptor blockers may reduce progression from mild cognitive impairment to dementia in patients undergoing antihypertensive treatment, researchers wrote in Hypertension.
Compared with ACE inhibitors, beta-blockers, calcium channel blockers, diuretic and no treatment at all, antihypertensive treatment using angiotensin receptor blockers (ARBs) was associated with lower risk for progression to dementia during a median of 3 years follow-up among patients with mild cognitive impairment and hypertension, according to the researchers.
“The angiotensin hypothesis has recently been proposed that the renin-angiotensin system plays a role in brain function. ... Medications that increase angiotensin-mediated activity at the angiotensin II and angiotensin IV receptors (eg, ARBs) may provide better brain protection compared with those decreasing activity at these receptors (eg, ACE inhibitors),” Zhenhong Deng, of the department of neurology at Sun Yat-sen Memorial Hospital, Sun Yat-sen University in Guangzhou, China, and colleagues wrote. “It remains unclear whether and to what extent ARBs are superior to ACE inhibitors in reducing progression to dementia in patients with mild cognitive impairment.”
Researchers investigated whether ARBs, compared with ACE inhibitors and other antihypertensive medications, may lower risk for progression from mild cognitive impairment to dementia in patients with hypertension.
Researchers used the Alzheimer’s Disease Neuroimaging Initiative, developed by the Laboratory of Neuro Imaging at University of Southern California, to identify 403 patients with hypertension and mild cognitive impairment at baseline (mean age, 74 years; 38% women). Data on antihypertensive medications received during a median follow-up of 3 years were self-reported.
During follow-up, 39.2% of participants progressed to dementia and the 3-year rate of progression-free survival was 67%.
In patients with hypertension and mild cognitive impairment, ARBs were associated with lower risk for progression to dementia compared with ACE inhibitors (adjusted HR = 0.45; 95% CI, 0.25-0.81; P = .023).
Compared with beta-blockers, calcium channel blockers and diuretics, ARB use was associated with lower risk for progression of mild cognitive impairment to dementia (aHR = 0.49; 95% CI, 0.27-0.89; P = .037).
Hypertension treatment with ARBs was also associated with lower risk for progression to dementia in patients with hypertension and mild cognitive impairment compared with no treatment (aHR = 0.31; 95% CI, 0.16-0.58; P = .001).
In adjusted analyses, treatment with ACE inhibitors did not affect progression of cognitive impairment compared with beta-blockers, calcium channel blockers and diuretics (P = .685) nor compared with no treatment (P = .179).
Moreover, antihypertensive treatment with beta-blockers, calcium channel blockers and diuretics did not prevent cognitive decline compared with no treatment in this cohort (P = .121).
“Overall, angiotensin II and IV may provide neuroprotection through angiotensin II and angiotensin IV receptors, although most evidence was based on experimental studies and the mechanisms were not fully understood,” the researchers wrote. “ARBs, which selectively block the angiotensin I receptors without inhibiting ACE and result in the relatively upregulated activities of angiotensin II and angiotensin IV receptors, and keep the pathway of amyloid beta degradation mediated by ACE intact, may offer superior protection than simultaneously lowering all the angiotensin receptors’ activities with ACE inhibitors.”
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