title: Do angiotensin receptor blockers prevent Alzheimer's disease?
abstract: OBJECTIVE
  The recent advances in our understanding of Alzheimer's disease pathophysiology and the renin angiotensin system pathways suggest that angiotensin receptor blockers (ARBs) are ideal drugs to explore for Alzheimer's disease therapy.
  
  
  RESULTS
  New evidence suggests that the brain renin angiotensin system has two opposing pathways: a damaging pathway and a neuro-protective pathway. Both pathways are involved in the amyloid hypothesis (Aβ cascades) and vascular mechanisms of Alzheimer's disease. Studies in animal models suggest that ARBs have cognitive protective effects that are related to their ability to decrease production and oligomerization and increase degradation of Aβ and their vascular effects (improve blood-brain barrier, restore endothelial function, decrease inflammation, and increase cerebral blood flow). Human observational studies have further suggested that ARB use is associated with decreased risk of Alzheimer's disease and protection against future cognitive decline. Our work has suggested that ARB use is associated with decreased amyloid deposition in the brain in Alzheimer's disease and can provide cognitive protection in those with mild cognitive impairment, a prodromal state for Alzheimer's disease, and dementia.
  
  
  CONCLUSIONS
  To date, no robust clinical trial of ARBs in Alzheimer's disease has been performed. All things being equal, it is reasonable to consider ARBs in those with cognitive risks.
authors.affiliation: Division of Geriatric, Hospital, Palliative and General Internal Medicine, University of Southern California, California, USA. ihajjar@usc.edu
authors.forename: Ihab
authors.initials: I
authors.lastname: Hajjar
authors.forename: Kathleen
authors.initials: K
authors.lastname: Rodgers
mesh_terms: D000544:Alzheimer Disease / Q000209:etiology* / Q000517:prevention & control*; D057911:Angiotensin Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000818:Animals; D001921:Brain / Q000378:metabolism / Q000473:pathology; D003071:Cognition / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications; D058225:Plaque, Amyloid / Q000150:complications; D012084:Renin-Angiotensin System
chemical_list: D057911:Angiotensin Receptor Antagonists