Relationship Between Antihypertensive Medications and Cognitive Impairment: Part I. Review of Human Studies and Clinical Trials

Curr Hypertens Rep. 2016 Aug;18(8):67. doi: 10.1007/s11906-016-0674-1.

Abstract

Purpose of review: There is an established association between hypertension and increased risk of poor cognitive performance and dementia including Alzheimer's disease; however, associations between antihypertensive medications (AHMs) and dementia risk are less consistent. An increased interest in AHM has resulted in expanding publications; however, none of the recent reviews are comprehensive. Our extensive review includes 15 observational and randomized controlled trials (RCTs) published over the last 5 years, assessing the relationship between AHM and cognitive impairment.

Recent findings: All classes of AHM showed similar result patterns in human studies with the majority of study results reporting point estimates below one and only a small number of studies (N = 15) reporting statistically significant results in favor of a specific class. Only a small number of studies reported statistically significant results in favor of a specific class of AHM. Methodological limitations of the studies prevent definitive conclusions. Further work is now needed to evaluate the class of AHM and cognitive outcomes in future RCTs, with a particular focus on the drugs with the promising results in both animals and human observational studies.

Keywords: Alzheimer’s disease; Antihypertensive medication; Cognitive decline; Dementia.

Publication types

  • Review

MeSH terms

  • Alzheimer Disease / physiopathology*
  • Alzheimer Disease / prevention & control*
  • Antihypertensive Agents / therapeutic use*
  • Cognitive Dysfunction / physiopathology*
  • Cognitive Dysfunction / prevention & control*
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / physiopathology*
  • Observational Studies as Topic
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Statistics as Topic

Substances

  • Antihypertensive Agents