Prevention of dementia: lessons from SYST-EUR and PROGRESS.
Hypertension is one of the principal risk factors for cerebrovascular diseases, closely correlated also with cognitive decline and dementia. Data from recent therapeutic trials (SYST-EUR, PROGRESS) open the way toward the prevention of dementia (vascular or Alzheimer's type) by antihypertensive treatments. The results of these two studies suggest different mechanisms of action of antihypertensive drugs in the prevention of cognitive decline. The use of angiotensin converting enzyme (ACE) inhibitors, with or without diuretics, resulted in decrease incidence of stroke-related dementia, but dementia without stroke was not reduced. With the dihydropyridine calcium antagonists, a reduction in both Alzheimer's type and vascular dementia was demonstrated.
Hanon
Olivier
O
Department of Geriatrics, Hôpital Broca, CHU Cochin Port-Royal, Université René Descartes, Paris V, 54/56 Rue Pascal, 75013 Paris, France. olivier.hanon@brc.ap-hop-paris.fr
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D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D015140:Dementia, Vascular / Q000517:prevention & control*; D006801:Humans; D016032:Randomized Controlled Trials as Topic
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents