title: [Effects of telmisartan on the level of Aβ1-42, interleukin-1β, tumor necrosis factor α and cognition in hypertensive patients with Alzheimer's disease].
abstract: OBJECTIVE
  To explore the effects of telmisartan, an angiotensin II type 1 receptor blocker with peroxisome proliferator-activated receptor γ-stimulating activity, on the levels of Aβ1-42, interleukin-1β (IL-1β), tumor necrosis factor-alpha (TNF-α) and cognition in elderly hypertensive patients with Alzheimer's disease (AD).
  
  
  METHODS
  A total of 48 patients with probable AD and essential hypertension were randomly assigned into telmisartan group (n = 24, 40 - 80 mg qd) or amlodipine group (n = 24, 5 - 10 mg qd) for 6 months at Henan Provincial People's Hospital during 2008 - 2011. Cognitive evaluations were assessed at pre-treatment and 24 weeks post-treatment by clinical assessment, rating scales and neuropsychological tests while the cerebrospinal fluid (CSF) levels of Aβ1-42, IL-1β and TNF-α by enzyme-linked immunosorbent assay (ELISA).
  
  
  RESULTS
  After 6 months, mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) significantly decreased compared with baseline values to a similar extent in both groups. No significant differences existed between two groups in SBP or DBP. The patients displayed significantly higher Aβ1-42 and greatly lower levels of IL-1β and TNF-α in the telmisartan group versus the amlodipine group (P < 0.05). At 24 weeks, the patients in the telmisartan group had better mini-mental state examination (MMSE) (22.0 ± 3.4) and Alzheimer's disease assessment scale-cognitive subscale (ADAS-cog) (15 ± 5) scales scores than those taking amlodipine (MMSE (19.5 ± 2.8) and ADAS-cog (18 ± 5). Patients treated with telmisartan had better improvement on the MMSE (P < 0.05) and ADAS-cog (P < 0.05) scales compared with the amlodipine group by the end of study week 24.
  
  
  CONCLUSIONS
  Telmisartan may delay the decreased level of Aβ1-42 and reduce the levels IL-1β and TNF-α in CSF so as to improve the cognitive function of elderly hypertensive patients with AD. With additional benefits in comparison with common antihypertensive drugs, it may offer a novel therapeutic strategy of AD.
authors.affiliation: Department of Neurology, Henan Provincial People's Hospital, Zhengzhou 450003, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Jie-wen
authors.initials: JW
authors.lastname: Zhang
authors.forename: Fen
authors.initials: F
authors.lastname: Lu
authors.forename: Ming-ming
authors.initials: MM
authors.lastname: Ma
authors.forename: Jiang-qiao
authors.initials: JQ
authors.lastname: Wang
authors.forename: Ai-qin
authors.initials: AQ
authors.lastname: Suo
authors.forename: Ying-ying
authors.initials: YY
authors.lastname: Bai
authors.forename: Hui-qin
authors.initials: HQ
authors.lastname: Liu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D017311:Amlodipine / Q000627:therapeutic use; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D001565:Benzoates / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D053583:Interleukin-1beta / Q000134:cerebrospinal fluid; D008297:Male; D008875:Middle Aged; D047495:PPAR gamma / Q000378:metabolism; D010446:Peptide Fragments / Q000134:cerebrospinal fluid; D000077333:Telmisartan; D014409:Tumor Necrosis Factor-alpha / Q000134:cerebrospinal fluid
chemical_list: D016229:Amyloid beta-Peptides; D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001565:Benzoates; D053583:Interleukin-1beta; D047495:PPAR gamma; D010446:Peptide Fragments; D014409:Tumor Necrosis Factor-alpha; C075222:amyloid beta-protein (1-42); D017311:Amlodipine; D000077333:Telmisartan