TY - JOUR T1 - DEsigning appropriate clinical trials to assess acei use and cognitive decline in older adults with hypertension AU - Todd S, McGuinness B, Passmore A Y1 - 2010/01/11 N1 - 10.1001/archinternmed.2009.463 JO - Archives of Internal Medicine SP - 107 EP - 107 VL - 170 IS - 1 N2 - Sink et al1 report that exposure to angiotensin-converting enzyme inhibitors (ACEIs) is not associated with dementia risk or cognitive decline in older hypertensive adults compared with other antihypertensive drugs. Centrally active ACEIs, ie, those that cross the blood-brain barrier (BBB) (animal data), reduced cognitive decline, whereas noncentrally acting ACEIs (BBB impermeable) were associated with greater risk of incident dementia and disability in instrumental activities of daily living.1 These effects were independent of blood pressure regulation and prompted a call for a randomized clinical trial of centrally active ACEIs in the prevention of cognitive decline and dementia.1 SN - 0003-9926 M3 - doi: 10.1001/archinternmed.2009.463 UR - http://dx.doi.org/10.1001/archinternmed.2009.463 ER -