-Blood pressure medication has been shown to protect against the development of dementia.
Dementia is common, affecting more the 4 million Americans and leads to more than 100 billion dollars in health care costs every year.
According to a recent study published in the July 13th issue of the medical journal, Archives of Internal Medicine, common blood pressure medication can decrease risk of developing dementia.

· Investigators showed that patients who used a certain type of ACE inhibitor (blood pressure medication) had a significant decrease in cognitive decline. The study included 1054 patients with high blood pressure.
Investigators found that the patients who were taking “centrally acting ACE Inhibitors” had a decrease in cognitive decline of 65% per year for every year they were taking the medication.
Centrally acting ACE Inhibitors are specific ACE Inhibitors which pass through the blood-brain barrier.
Centrally acting ACE Inhibitors include the medications:
benazepril
enalapril
fosinopril
lisinopril
moexipril
quinapril
ramipril

· The benefit seen with these medications is likely due to their effect on inhibiting the renin-angiotensin system in the brain. The renin-angiotensin system is involved in memory and brain function. Excessive activity of the renin angiotensin system in the brain also leads to the production of inflammatory molecules which can harm brain tissue.
Both of these processes likely contribute to the decrease in the development of dementia.

· This study is very important and provides new insight into the benefits of certain ACE Inhibitors. If the results are confirmed with additional studies, the above blood pressure medications will likely be a standard treatment for all elderly people with high blood pressure.

Cristopher Geiler, M.D.
July 28th 2009

Reference
Arch Intern Med. 2009;169:1195-1202