Stress-induced blood pressure elevation in subjects with mild cognitive impairment: effects of the dual-type calcium channel blocker, cilnidipine.
OBJECTIVE
We investigated whether mental stress-induced blood pressure elevation was related to cognitive function in the elderly, and further examined the effects of the dual-type calcium channel blocker, cilnidipine, on stress induced hypertension in subjects with mild cognitive impairment.


METHODS
In study I, 39 consecutive outpatients (mean age +/- standard deviation, 77 +/- 8 years), who were referred to our memory clinic and were not taking any medications, were studied. They were divided into three groups according to cognitive function on the Hasegawa Dementia Scale-Revised (HDSR): group 1 (n = 8), 28 points or more; group 2 (n = 18), 21-27 points; and group 3 (n = 13), 20 points or less. In study II, 14 outpatients with hypertension and mild cognitive impairment (aged 79 +/- 8 years; HDSR score, 24 +/- 4) were assigned to receive cilnidipine (10-20 mg/day). The control group (n = 10) matched for age, HDSR and blood pressure was followed without cilnidipine.


RESULTS
In study I, although age and basal blood pressure were similar among the three groups, the blood pressure response to a mental arithmetic test was twice as large in group 2 (26 +/- 12 mmHg in systolic pressure and 11 +/- 8 mmHg in diastolic pressure) as those in groups 1 and 3. In study II, after 4 weeks, cilnidipine treatment significantly decreased the blood pressure responses to the mental arithmetic test compared to the baseline as well as to those of the control group.


CONCLUSIONS
Stress-induced blood pressure elevations are exaggerated in subjects with mild cognitive impairment. Cilnidipine may have inhibitory effects on stress-induced hypertension.
Kawashima
Yumiko
Y
Department of Geriatric Medicine, Kyorin University School of Medicine, Mitaka, Japan.
Akishita
Masahiro
M
Hasegawa
Hiroshi
H
Kozaki
Koichi
K
Toba
Kenji
K
D000368:Aged; D000369:Aged, 80 and over; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000150:complications*; D004095:Dihydropyridines / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology*; D013315:Stress, Psychological
D002121:Calcium Channel Blockers; D004095:Dihydropyridines; C065927:cilnidipine