PS 17-47 EFFECTS OF RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM BLOCKADE MEDICATIONS ON COGNITION FUNCTION IN HYPERTENSION: HEAD-TO-HEAD COMPARISONS OF VARIOUS CLASSES OF ANTIHYPERTENSIVE DRUGS – OVERVIEW AND META-ANALYSES

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Abstract

Objective:

Renin-Angiotensin-Aldosterone System inhibitor has shown mechanized advantages of improving cognition function in animal models. However, clinical practices reported inconsistent results.

Design and method:

We searched the databases of PubMed, Embase, Cochrane Library, Web of Science (up to Dec.2015) and supplemented by manual retrieval. Fourteen two-drugs comparison's randomized controlled trials (4926 individuals analyzing head to head comparisons of ACEI or ARB with other antihypertensive drugs) on cognition function were included. The effect of antihypertensive drugs on cognition decline was evaluated. Methodological quality was evaluated by Cochrane handbook 5.1.0 and meta-analyses were conducted by using RevMan 5.3.0 software.

Results:

In total, 14 clinical trials involving 4926 patients were included. Angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) had benefits on overall cognition function decline (0.48, 95% CI [0.21–0.74], P = 0.0004). ARBs had larger benefits than other antihypertension drugs on overall cognition (1.24, 95% CI [1.06,1.43], P = 0.00001). However ACEI had not show advantages compared with other class drugs for cognition function (0.15, 95% CI [-0.04,0.33], P = 0.12). The mean change in blood pressure did not differ significantly between the different antihypertensive drug classes.

Conclusions:

Angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) has beneficial effects on cognition function. ARB possibly was most effective compared with other antihypertensive drugs.

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