Blood-Brain Barrier Crossing Renin-Angiotensin Drugs and Cognition in the Elderly: A Meta-Analysis
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- Jean K. Ho
- Institute for Memory Impairments and Neurological Disorders (J.K.H., D.A.N.), University of California, Irvine.
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- Frank Moriarty
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin (F.M.).
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- Jennifer J. Manly
- Department of Neurology, Gertrude H. Sergievsky Center, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York (J.J.M.).
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- Eric B. Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA (E.B.L.).
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- Denis A. Evans
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL (D.A.E., K.B.R.).
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- Kumar B. Rajan
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL (D.A.E., K.B.R.).
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- Elizabeth M. Hudak
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa (E.M.H.).
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- Lamiaa Hassan
- Institute of Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Saxony-Anhalt, Germany (L.H.).
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- Enwu Liu
- Mary MacKillop Institute for Health Research, Australian Catholic University (E.L.).
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- Nobuyuki Sato
- Department of Cardiovascular Medicine, Asahikawa Medical University, Japan (N.S., N.H.).
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- Naoyuki Hasebe
- Department of Cardiovascular Medicine, Asahikawa Medical University, Japan (N.S., N.H.).
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- Danielle Laurin
- Centre d’excellence sur le vieillissement de Québec, Centre de recherche du CHU de Québec and VITAM-Centre de recherche en santé durable, Canada (D.L., P-H.C.).
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- Pierre-Hugues Carmichael
- Centre d’excellence sur le vieillissement de Québec, Centre de recherche du CHU de Québec and VITAM-Centre de recherche en santé durable, Canada (D.L., P-H.C.).
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- Daniel A. Nation
- Institute for Memory Impairments and Neurological Disorders (J.K.H., D.A.N.), University of California, Irvine.
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説明
<jats:p>Hypertension is an established risk factor for cognitive decline and dementia in older adults, highlighting the potential importance of antihypertensive treatments in prevention efforts. Work surrounding antihypertensive treatments has suggested possible salutary effects on cognition and neuropathology. Several studies have specifically highlighted renin-angiotensin system drugs, including AT1-receptor blockers and angiotensin-converting-enzyme inhibitors, as potentially benefiting cognition in later life. A small number of studies have further suggested renin-angiotensin system drugs that cross the blood-brain barrier may be linked to lower dementia risk compared to their nonpenetrant counterparts. The present meta-analysis sought to evaluate the potential cognitive benefits of blood-brain barrier crossing renin-angiotensin system drugs relative to their nonpenetrant counterparts. We harmonized longitudinal participant data from 14 cohorts from 6 countries (Australia, Canada, Germany, Ireland, Japan, United States), for a total of 12 849 individuals at baseline, and assessed for blood-brain barrier crossing potential within antihypertensive medications used by cognitively normal participants. We analyzed 7 cognitive domains (attention, executive function, language, verbal memory learning, recall, mental status, and processing speed) using ANCOVA (adjusted for age, sex, and education) and meta-analyses. Older adults taking blood-brain barrier-crossing renin-angiotensin drugs exhibited better memory recall over up to 3 years of follow-up, relative to those taking nonpenetrant medications, despite their relatively higher vascular risk burden. Conversely, those taking nonblood-brain barrier-penetrant medications showed better attention over the same follow-up period, although their lower vascular risk burden may partially explain this result. Findings suggest links between blood-brain barrier crossing renin-angiotensin drugs and less memory decline.</jats:p>
収録刊行物
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- Hypertension
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Hypertension 78 (3), 629-643, 2021-09
Ovid Technologies (Wolters Kluwer Health)
