Some Blood Pressure Drugs May Improve Brain Health

Alonzo Osche

Whether certain blood pressure medications come with added benefits for the brain is still in question. But this latest study “gets us one step closer to better understanding” the relationship between blood pressure and brain health and the potential influence medications may have, says Dave Dixon, associate professor and vice chair for clinical services at Virginia Commonwealth University’s School of Pharmacy, who was not involved in the study.

Nearly half of adults in the U.S. have high blood pressure, and most take medicine to lower it, federal data shows. High blood pressure is defined as 130/80 millimeters of mercury (mm Hg) or higher. ACE inhibitors and ARBs are just two classes of blood pressure-lowering drugs; they work by acting on the body’s renin-angiotensin system, which regulates blood pressure.

A handful of medicines in these two classes have properties that enable them to penetrate the brain, where they could have a localized effect, explains study coauthor Daniel Nation, an associate professor of psychological science at the University of California, Irvine — especially because in the brain, the renin-angiotensin system “is believed to be involved in functions critical to cognition,” the researchers write.

What they found in their meta-analysis is that adults who took the brain-penetrating ACE inhibitors or ARBs had better memory recall over a three-year follow-up than those who took blood pressure medication that didn’t cross the blood-brain barrier.

“This is one of these situations where it may be that there’s just this other benefit that really is distinct, based on the fact that [the medicine] is getting into the brain and hitting those pathways,” Nation says about the results.

Researchers didn’t see a difference between the two groups in other cognitive parameters such as learning, language skills and executive function. However, adults who took the drugs that didn’t cross the blood-brain barrier scored better on attention, which the researchers note was unexpected and warrants further investigation.

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