It is well known that hypertension is a health threat, increasing the risk of heart attack or stroke as well as kidney problems. And it is also known that when the pressure is brought back to acceptable values over time, both with adequate lifestyles and also and above all with the drugs prescribed by the doctor when necessary, it is also known. Suffice it to say that, according to the results of the Sprint Mind study, the correct treatment of hypertension reduces the occurrence of cognitive impairment in adults by about one fifth.
But now a meta-analysis, that is a critical rereading of a series of clinical studies, published in Hypertension, adds a new piece on the theme. Some drugs, in particular those that are part of the family of Ace inhibitors and angiotensin-2 inhibitors, would be able to more significantly affect cognitive performance, including memory, thanks to their ability to bypass that sort of “customs” between blood and nervous system which is called the blood brain barrier. The study, coordinated by Daniel A. Nation, of the Institute for Memory Impairments and Neurological Disorders at the University of California at Irvine, has examined different classes of antihypertensive therapies, such as ace-inhibitors, angiotensin II receptor blockers, calcium channel blockers and diuretics.
The analysis examined 14 different clinical studies on just under 13,000 people over-50 in different countries of the world, coming to the conclusion that drugs able to cross the “barrier” between blood and nervous system could have a more marked effect on the memory retention front, in the three-year controls, even in the presence of a higher cardiovascular risk. This is an important test, according to American experts, on the role of specific protection of some antihypertensives on cognitive decline. Several aspects were considered in the various studies, fromattention, until to language and learning skills, in addition of course to ability to keep memories. The data is particularly significant considering that hypertension represents a possible cause of cognitive impairment, since it negatively affects the flow of blood and oxygen to the brain.
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“The research is certainly very interesting and gives further proof of the importance of correct blood pressure control in terms of preventing cognitive decline – he explains. Claudio Borghi, professor of Internal Medicine at the University of Bologna. Above all, it allows us to understand one more aspect: what happens in terms of cognitive aspects occurs inside the skull, therefore the mechanisms that are established can be more easily subject to the action of drugs that regulate the renin-angiotensin-aldosterone system. even in that area. Being able to modulate these mechanisms in the brain tissue with drugs means not only counteracting vasoconstriction but also dealing with any other problems “.
It is also possible to hypothesize how the medicines can act there. “We can imagine both a direct effect and an indirect effect, based on the regulation of the microcirculation – concludes Borghi. It is therefore an important scientific fact that must not however make us forget that, in all cases, the treatment of hypertension is fundamental for the well-being of the organism and the nervous system and must always be set by the doctor, case by case. but above all to be followed regularly by the patient “.
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