Do sartans reduce the risk of cognitive impairment in the course of hypertension?

Abstract

Long term, particularly uncontrolled hypertension causescognitive impairment. The results of recent meta-analyzeson the effects of antihypertensive drug therapy on the inhibitionof cognitive impairment are different. In some ofthem there was a small, but significant reduction in the riskof developing dementia, other did not confirm the beneficialeffect of these drugs. In 2004, Fournier hypothesizedthat some antihypertensive drugs have properties inhibitthe growth of cognitive impairment in patients with hypertension.These include calcium channel blockers, particularlysartans, that work by AT2 and AT4 receptors located inthe brain tissue. Our study discusses the number of experimentalresearches in animals and in vitro studies, whichindirectly confirm a significant positive influence sartans toreduce the risk of dementia in patients with hypertension.These drugs improve the cerebral blood flow, reduced inpatients with impaired cognitive ability, have anti-inflammatoryeffect and reduce oxidative stress in brain tissue,and may also inhibit the deposition of beta-amyloid inthe central nervous system. Clinical studies on this issueare still few. However, both epidemiological observationsand relatively small observational studies indicate to thebenefits of sartans in order to reduce the risk of dementiain patients with hypertension. This year was published meta-analysis of Marpillat et al, which showed that in patientswith uncomplicated hypertension only sartans (and up to40%) reduce the risk of developing cognitive impairment.The current observations support the original hypothesisof Fournier and now sartans therapy gives hopes fora more effective prevention of dementia in patients withhypertension.