Centrally Active ACE Inhibitors may help to prevent Dementia

New observational data from the Cardiovascular Health Study show that centrally active angiotensin-converting enzyme (ACE) inhibitors reduce cognitive decline by 65% per year of exposure, an effect that is likely due to their ability to cross the blood-brain barrier.

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http://cme.medscape.com/viewarticle/706868

Reduced Incidence Likely Not Due to Antihypertensive Effect

“Our most important findings in this observational study were that centrally acting ACE inhibitors were associated with a 65% reduction in cognitive decline per year of taking the centrally active ACE inhibitors,” said Dr. Sink.

“In addition, compared with participants with high blood pressure who took other types of blood-pressure–lowering medications, non–centrally active ACE inhibitors did not have this effect and might be associated with a greater risk for incremental dementia, and  that cumulative (or chronic) exposure to ACE inhibitors may be needed to achieve the protective effect,” Dr. Sink said.

The researchers suspect that this difference is due primarily not to the antihypertensive effects of centrally acting ACE inhibitors but to their effect on the brain’s intrinsic renin-angiotensin system, which is involved in memory and cognition.