title: Relationship Between Antihypertensive Medications and Cognitive Impairment: Part II. Review of Physiology and Animal Studies.
abstract: There is an established association between hypertension and increased risk of poor cognitive performance and dementia including Alzheimer's disease; however, associations between antihypertensive medications (AHM) and dementia risk are less clear. An increased interest in AHM has resulted in expanding publications; however, none of the recent reviews provide comprehensive review. Our extensive review includes 24 mechanistic animal and human studies published over the last 5 years assessing relationship between AHM and cognitive function.
  
  
  
  All classes of AHM showed similar result patterns in animal studies. The mechanism by which AHM exert their effect was extensively studied by evaluating well-established pathways of AD disease process, including amyloid beta (Aβ), vascular, oxidative stress and inflammation pathways, but only few studies evaluated the blood pressure lowering effect on the AD disease process. Methodological limitations of the studies prevent comprehensive conclusions prior to further work evaluating AHM in animals and larger human observational studies, and selecting those with promising results for future RCTs.
authors: School of Public Health, Imperial College London, London, SW7 2AZ, UK. r.peters@imperial.ac.uk.
authors: Ruth
authors: R
authors: Peters
authors: Department of Medicine, Division of Geriatric Medicine & Gerontology, Johns Hopkins School of Medicine, Baltimore, MD, 21224, USA.
authors: Mattan
authors: M
authors: Schuchman
authors: School of Health and Related Research, University of Sheffield, Sheffield, UK.
authors: Jean
authors: J
authors: Peters
authors: Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, Baltimore, MD, 21205, USA.
authors: Michelle C
authors: MC
authors: Carlson
authors: Department of Medicine, Division of Geriatric Medicine & Gerontology, Johns Hopkins School of Medicine, Baltimore, MD, 21224, USA.
authors: Sevil
authors: S
authors: Yasar
mesh_terms: D000544:Alzheimer Disease / Q000503:physiopathology / Q000517:prevention & control; D016229:Amyloid beta-Peptides / Q000502:physiology; D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects / Q000502:physiology; D060825:Cognitive Dysfunction / Q000503:physiopathology* / Q000517:prevention & control*; D004195:Disease Models, Animal; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology*; D012307:Risk Factors
chemical_list: D016229:Amyloid beta-Peptides; D000959:Antihypertensive Agents
keywords: Alzheimer’s disease; Antihypertensive medication; Cognitive decline; Dementia