EFFECTS OF ANTIHYPERTENSIVE THERAPY ON COGNITIVE DECLINE AND BIOCHEMICAL MARKERS IN HYPERTENSIVE PATIENTS WITH INCREASED RISK FOR ALZHEIMER’S DISEASE
Main Article Content
Keywords
Hypertension, Cognitive Decline, Alzheimer's Disease
Abstract
Hypertension is a modifiable risk factor for cognitive decline and Alzheimer's disease (AD). This randomized controlled trial aimed to evaluate the effects of antihypertensive therapy on cognitive function and biochemical markers in hypertensive patients at increased risk for AD. A total of 200 participants aged 60–80 years with diagnosed hypertension and mild cognitive impairment were randomized into two groups: one receiving standard antihypertensive treatment and the other receiving intensive antihypertensive therapy targeting lower blood pressure goals. Over 24 months, cognitive assessments and biochemical analyses, including amyloid-beta and tau protein levels, were conducted. The intensive therapy group showed a statistically significant improvement in cognitive scores (p<0.01) and a reduction in AD-related biomarkers (p<0.05) compared to the standard treatment group. These findings suggest that intensive blood pressure management may slow cognitive decline and modulate biochemical markers associated with AD in hypertensive patients. Further long-term studies are warranted to confirm these results.
References
. DOI: https://doi.org/10.1002/alz.076777(Alzheimer's Journals)
2. Guo Y, Tan CC, Tan MS, et al. Anti-hypertensive drugs moderate the relationship of blood pressure with Alzheimer’s pathologies and neurodegenerative markers in non-demented hypertensive older adults. J Prev Alzheimers Dis. 2024;11(5):672–683. DOI: https://doi.org/10.14283/jpad.2024.40(SpringerLink)
3. Jing B, Liu X, Graham LA, et al. Deprescribing of antihypertensive medications and cognitive function in nursing home residents. JAMA Intern Med. 2024;184(11):1347–1355. DOI: https://doi.org/10.1001/jamainternmed.2024.4851(JAMA Network)
4. Peters R, Xu Y, Fitzgerald O, et al. Blood pressure lowering and prevention of dementia: an individual patient data meta-analysis. Eur Heart J. 2022;43(48):4980–4990. DOI: https://doi.org/10.1093/eurheartj/ehac584(American Heart Association Journals)
5. Beaman EE, Bonde AN, Larsen SMU, et al. Blood-brain barrier permeable β-blockers linked to lower risk of Alzheimer’s disease in hypertension. Brain. 2023;146(3):1141–1151. DOI: https://doi.org/10.1093/brain/awac076(American Heart Association Journals)
6. Sible IJ, Nation DA. Blood pressure variability and cognitive decline: a post hoc analysis of the SPRINT MIND trial. Am J Hypertens. 2023;36(2):168–175. DOI: https://doi.org/10.1093/ajh/hpac128(American Heart Association Journals)
7. van Rijssel AE, Stins BC, Beishon LC, et al. Effect of antihypertensive treatment on cerebral blood flow in older adults: a systematic review and meta-analysis. Hypertension. 2022;79(5):1067–1078. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.121.18255(American Heart Association Journals)
8. Scotti L, Bassi L, Soranna D, et al. Association between renin-angiotensin-aldosterone system inhibitors and risk of dementia: a meta-analysis. Pharmacol Res. 2021;166:105515. DOI: https://doi.org/10.1016/j.phrs.2021.105515(BioMed Central)
9. Nassan M, Daghlas I, Piras IS, et al. Evaluating the association between genetically proxied ACE inhibition and dementias. Alzheimer's Dement. 2023;19(11):3894–3901. DOI: https://doi.org/10.1002/alz.12993(BioMed Central)
10. Ou YN, Yang YX, Shen XN, et al. Genetically determined blood pressure, antihypertensive medications, and risk of Alzheimer’s disease: a Mendelian randomization study. Alzheimer's Res Ther. 2021;13(1):41. DOI: https://doi.org/10.1186/s13195-021-00776-3(BioMed Central)
11. Beishon L, Haunton VJ, Panerai RB. Antihypertensives in dementia: good or bad for the brain? J Cereb Blood Flow Metab. 2023;43(10):1467–1476. DOI: https://doi.org/10.1177/0271678X221133473(SAGE Journals)
12. Pruzin JJ. Middle age prevention of future Alzheimer’s disease and related dementias with intensive treatment of hypertension: Middle PATH clinical trial proposal. Alzheimer's Dement. 2023;19(S23). DOI: https://doi.org/10.1002/alz.079423(Alzheimer's Journals)
13. Freeman MW, Halvorsen YD, Marshall W, et al. Phase 2 trial of baxdrostat for treatment-resistant hypertension. N Engl J Med. 2023;388(5):395–405. DOI: https://doi.org/10.1056/NEJMoa2213169(American Heart Association Journals)
14. Desai AS, Webb DJ, Taubel J, et al. Zilebesiran, an RNA interference therapeutic agent for hypertension. N Engl J Med. 2023;389(3):228–238. DOI: https://doi.org/10.1056/NEJMoa2208391(American Heart Association Journals)
15. Peters R, Beckett N, Forette F, et al. Incidence of dementia and blood pressure lowering in the Hypertension in the Very Elderly Trial cognitive function assessment (HYVET-COG): a double-blind, placebo-controlled trial. Lancet Neurol. 2008;7(8):683–689. DOI: https://doi.org/10.1016/S1474-4422(08)70143-1
16. Systolic Blood Pressure Intervention Trial (SPRINT) Research Group. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373(22):2103–2116. DOI: https://doi.org/10.1056/NEJMoa1511939
17. Williamson JD, Pajewski NM, Auchus AP, et al. Effect of intensive vs standard blood pressure control on probable dementia: a randomized clinical trial. JAMA. 2019;321(6):553–561. DOI: https://doi.org/10.1001/jama.2018.21442
18. Kuo HK, Sorond F, Iloputaife I, et al. Effect of blood pressure on cognitive functions in elderly persons. J Gerontol A Biol Sci Med Sci. 2004;59(11):1191–1194. DOI: https://doi.org/10.1093/gerona/59.11.1191
19. Launer LJ, Hughes TM, White LR. Midlife blood pressure and dementia: the Honolulu–Asia aging study. Neurobiol Aging. 2011;32(12):2103–2109. DOI: https://doi.org/10.1016/j.neurobiolaging.2009.12.020
20. Yasar S, Xia J, Yao W, et al. Antihypertensive drugs decrease the risk of Alzheimer's disease: Ginkgo Evaluation of Memory Study. Neurology. 2013;81(10):896–903. DOI: https://doi.org/10.1212/WNL.0b013e3182a351ae
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Javeria Sarfraz
MBBS, Mphil, Pharmacology Associate Professor, Allama Iqbal Medical College Lahore
Iram Mustafa
Demonstrator, BDS, MPhil Biochemistry, Bakhtawar Amin Medical and Dental College, Multan
Muhammad Tahir
Associate Professor of Pharmacology, HBS Medical and Dental College Islamabad
Muhammad Usman
MBBS,Mphi, Assistant Professor, Pharmacology,Islam Medical College, Sialkot
Zobia Mushtaq
Professor of pharmacology, MPhil pharmacology, FMU Faisalabad
Waleed Arshad
Assistant Professor, M.Phil Pharmacology, Queens medical college
Farah Naz Tahir
MBBS, Mphil, Phd, Associate Professor of Biochemistry, Central Park Medical College, Lahore, Pakistan