RT Journal
A1 Hajjar I, Hart M, Chen Y, et al
T1 Effect of antihypertensive therapy on cognitive function in early executive cognitive impairment: A double-blind randomized clinical trial
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2012
FD March 12
VO 172
IS 5
SP 442
OP 444
DO 10.1001/archinternmed.2011.1391
UL http://dx.doi.org/10.1001/archinternmed.2011.1391
AB 
Approximately 50% of older hypertensive individuals have difficulties in executive function, the cognitive domain that controls complex tasks.1 Hypertensive individuals with executive dysfunction have a high rate of conversion to dementia.2 To our knowledge, to date, no study has investigated therapeutic options for executive dysfunction. Recent evidence suggests that the renin angiotensin system plays a central role in linking hypertension to cognitive function, offering new therapeutic options for cognitive protection.3 In the brain, angiotensin receptor blockers (ARBs) block the type 1 but not the type 2 receptor, whereas angiotensin-converting enzyme inhibitors (ACEIs) decrease activation of both receptors. Activating the type 2 receptor may provide cognitive protection.4 We therefore hypothesized that an ARB-based regimen would be superior to other antihypertensive regimens in cognitive protection, especially executive function, and conducted a 12-month double-blind randomized clinical trial comparing candesartan, lisinopril, and hydrochlorothiazide in hypertensive individuals with early executive dysfunction.