Antihypertensive Therapy and Cerebral Hemodynamics in Executive Mild Cognitive Impairment:: Results of a Pilot Randomized Clinical Trial

• Autores: Ihab Hajjar, Meaghan Hart, Yu Ling Chen, Wendy J. Mack, Vera Novak, Helena C. Chui, Lewis A. Lipsitz
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 61, Nº. 2, 2013, págs. 194-201
• Idioma: inglés
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• Dialnet Métricas: 1 Cita
• Resumen

  • Objectives: To compare the effects of three antihypertensive medications on cerebral hemodynamic and cognitive function in hypertensive individuals with executive dysfunction.

    Design: Double-blind randomized clinical trial.

    Setting: Community.

    Participants: Fifty-three individuals aged 60 and older with hypertension and executive dysfunction.

    Intervention: Lisinopril, candesartan, or hydrochlorothiazide for 1 year.

    Measurements: Cerebral blood flow velocity (BFV; transcranial Doppler ultrasonography during rest, sitting, standing, hypercapnia, and hypocapnia), cognition, and blood pressure were measured at baseline and after 6 and 12 months. Linear mixed models were used to compare the three groups.

    Results: Of the 53 participants, 47 had successful insonation (mean age 72; 70% white; 57% women). There was a tendency toward an increase in BFV in the candesartan group and a decrease in the lisinopril and hydrochlorothiazide groups (between-group P = .57) that was significant in those with low BFV at baseline (

    Conclusion: Angiotensin receptor blockers may preferentially preserve cerebral hemodynamics and executive function in individuals with executive dysfunction. These findings warrant further investigation in a larger trial.