Effects of six anti-hypertensive medications on cognitive performance.
OBJECTIVE
To describe and compare the effects of six different antihypertensive medications on cognitive performance.


METHODS
Prospective, randomized, and double-blind with treatment cross-over.


METHODS
University hypertension clinic and neuropsychology laboratory.


METHODS
Ninety-eight Caucasian men between 25 and 55 years of age with mild-to-moderate essential hypertension (88 of whom completed the study), and 32 normotensive men with similar socio-demographic characteristics.


METHODS
Six-week treatment periods with atenolol, metoprolol, hydrochlorothiazide, methyldopa, enalapril and verapamil, and 2-week placebo baseline and wash-out periods.


METHODS
In-depth neuropsychological assessments and several mood questionnaires were completed during placebo (baseline) periods and active treatment periods. Practice effects due to repeated neuropsychological testing were estimated from data collected concurrently in the normotensive participants.


RESULTS
The antihypertensive treatments lowered blood pressure comparably and did not affect mood or anxiety. Small treatment effects were noted in four of seven domains of cognitive performance. Irrespective of medication type, treatment reduced the simple motor speed (P < 0.001), and slowed completion of two tests measuring perceptuo-motor speed and mental flexibility (P </= 0.05). Manual dexterity declined somewhat with metoprolol and methyldopa (P = 0.01). In contrast, all antihypertensive agents favorably affected performance on several tests that require working memory (P < 0.01). Performance on other tests assessing grip strength, learning and memory, attention and executive function was not affected.


CONCLUSIONS
Short-term treatment with standard antihypertensive medications was associated with some small decrements in psychomotor performance and small improvements in working memory, without notable drug-class differences. Long-term effects await further study.
Muldoon
Matthew F
MF
Division of Clinical Pharmacology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15260, USA. mfm10@pitt.edu
Waldstein
Shari R
SR
Ryan
Christopher M
CM
Jennings
John Richard
JR
Polefrone
Joanna M
JM
Shapiro
Alvin P
AP
Manuck
Stephen B
SB
D000328:Adult; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000523:psychology*; D008297:Male; D008568:Memory / Q000187:drug effects; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000187:drug effects
D000959:Antihypertensive Agents