title: Usefulness of ARBs and ACE inhibitors in the prevention of vascular dementia in the elderly.
abstract: Hypertension is a leading risk factor for vascular dementia. With the increasing burden of dementia, prevention and delay of cognitive decline are becoming a priority. Recent clinical trials have demonstrated that patients taking antihypertensive medications have a reduced incidence of dementia and cognitive impairment. Calcium channel blockers, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers appear to offer significant neuroprotection, even beyond blood pressure reduction. Evidence is emerging that the angiotensin receptor blockers offer superior neuroprotection. This finding has been attributed to the unique property of sustained blockade of the AT1 receptor, combined with simultaneous activation of the AT2 receptors. The use of angiotensin receptor blockers as first-line therapy for hypertension and cognitive protection in the elderly should be strongly considered.
authors.affiliation: Division of Nephrology, University of Maryland School of Medicine, Baltimore, MD 21201, USA. dhanes@medicine.umaryland.edu
authors.forename: Donna S
authors.initials: DS
authors.lastname: Hanes
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Weir
mesh_terms: D000368:Aged; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000145:classification / Q000627:therapeutic use*; D015140:Dementia, Vascular / Q000453:epidemiology / Q000517:prevention & control*; D015577:Geriatric Assessment; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D012307:Risk Factors; D020521:Stroke / Q000150:complications
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents