1887
Volume 2025, Issue 4
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Globally, cognitive impairment has evolved as a major health and social issue. Hypertension, age, and stroke are independent risk factors for the development of cognitive impairment. Elderly individuals with hypertension are more prone to earlier cognitive decline. The risk is reduced by proper antihypertensive treatment. Various classes of antihypertensive drugs have varied protective effects on cognition, so we aimed to compare the cognitive scores of individuals taking different classes of antihypertensive drugs and correlate the blood pressure levels with their cognitive scores.

Known hypertensive individuals belonging to the age group of 35 to 60 years participated in this single-center cross-sectional study conducted in a tertiary care center in southern India. Individuals with any chronic systemic illness or any history of pre-existing cognitive impairment were excluded from the study. After taking a detailed history on hypertension and drug history, the patient’s cognition was assessed using the Montreal Cognitive Assessment (MoCA) test. Out of a total score of 30, greater than or equal to 26 is considered normal. The hypertensive individuals were divided into three groups, namely those who were taking Angiotensin Receptor Blockers (ARBs), Calcium Channel Blockers (CCBs), and other antihypertensive drugs, and their cognitive scores were compared.

Two hundred and forty-nine known hypertensive individuals participated in the study, of whom 43% were found to be males. Patients on ARBs (25.1 ± 3) had higher cognitive scores compared to CCBs (22.6 ± 3.8) and other antihypertensive drugs (24.3 ± 3.8). When the cognitive scores were correlated with mean arterial pressure, it showed a negative association was shown (-value, 0.45). When grouped individually and analyzed using an independent t-test, patients who have been hypertensive for more than 5 years and who were on irregular treatment showed lower cognitive scores, which is statistically significant.

Our study showed a strong association between hypertension and cognitive function decline, and also the ARBs’ protective effect over other classes of antihypertensive drugs. The pharmacodynamics of different classes of antihypertensive drugs should be taken into account to support the cognitive health of hypertensive individuals.

© 2025 Deepalakshmi, Vijayabaskaran, Subhiksha, licensee HBKU Press.
Loading

Article metrics loading...

/content/journals/10.5339/qmj.2025.106
2025-12-10
2025-12-13

Metrics

Loading full text...

Full text loading...

/deliver/fulltext/qmj/2025/4/qmj.2025.106.html?itemId=/content/journals/10.5339/qmj.2025.106&mimeType=html&fmt=ahah

References

  1. Murman DL. The impact of age on cognition. Semin Hear. 2015 Aug; 36:(3):111–21. https://doi.org/10.1055/s-0035-1555115
    [Google Scholar]
  2. Sebastian MJ, Khan SK, Pappachan JM, Jeeyavudeen MS. Diabetes and cognitive function: an evidence-based current perspective. World J Diabetes. 2023 Feb; 14:(2):92–109. https://doi.org/10.4239/wjd.v14.i2.92
    [Google Scholar]
  3. Qin J, He Z, Wu L, Wang W, Lin Q, Lin Y, et al. Prevalence of mild cognitive impairment in patients with hypertension: a systematic review and meta-analysis. Hypertens Res. 2021 Oct; 44:1251–60. https://doi.org/10.1038/s41440-021-00704-3
    [Google Scholar]
  4. Jack CR Jr, Bennett DA, Blennow K, et al. NIA-AA Research Framework: toward a biological definition of Alzheimer’s disease. Alzheimers Dement. 2018 Apr; 14:(4):535–62. https://doi.org/10.1016/j.jalz.2018.02.018
    [Google Scholar]
  5. Canavan M, O’Donnell MJ. Hypertension and cognitive impairment: a review of mechanisms and key concepts. Front Neurol. 2022 Feb; 13:821135. https://doi.org/10.3389/fneur.2022.821135
    [Google Scholar]
  6. Liu Y, Dong YH, Lyu PY, Chen WH, Li R. Hypertension-induced cerebral small vessel disease leading to cognitive impairment. Chin Med J (Engl). 2018 Mar; 131:(5):615–9. https://doi.org/10.4103/0366-6999.226069
    [Google Scholar]
  7. Hughes D, Judge C, Murphy R, Loughlin E, Costello M, Whiteley W, et al. Association of blood pressure lowering with incident dementia or cognitive impairment: a systematic review and meta-analysis. JAMA. 2020 May; 323:(19):1934–44. https://doi.org/10.1001/jama.2020.4249
    [Google Scholar]
  8. Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005 Apr; 53:(4):695–9. https://doi.org/10.1111/j.1532-5415.2005.53221.x
    [Google Scholar]
  9. Abdolahi A, Bull MT, Darwin KC, Venkataraman V, Grana MJ, Dorsey ER, et al. A feasibility study of conducting the Montreal Cognitive Assessment remotely in individuals with movement disorders. Health Informatics J. 2016 Jun; 22:(2):304–11. https://doi.org/10.1177/1460458214556373
    [Google Scholar]
  10. Peters R, Schuchman M, Peters J, Carlson MC, Yasar S. Relationship between antihypertensive medications and Cognitive Impairment: Part II. Review of Physiology and Animal Studies. Curr Hypertens Rep. 2016 Aug; 18:(8):66. https://doi.org/10.1007/s11906-016-0673-2
    [Google Scholar]
  11. Yang W, Luo H, Ma Y, Si S, Zhao H. Effects of antihypertensive drugs on cognitive function in elderly patients with hypertension: a review. Aging Dis. 2021 Jun; 12:(3):841–51. https://doi.org/10.14336/AD.2020.1111
    [Google Scholar]
  12. Briasoulis A, Agarwal V, Messerli FH. Alcohol consumption and the risk of hypertension in men and women: a systematic review and meta-analysis. J Clin Hypertens (Greenwich). 2012 Nov; 14:(11): 792–8. https://doi.org/10.1111/jch.12008
    [Google Scholar]
  13. Kelso IG, Tadi P. Cognitive assessment. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2020 Nov 20. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556049/. Accessed on April 30, 2025.
     [Google Scholar]
  14. Aronow WS. Hypertension and cognitive impairment. Ann Transl Med. 2017 Jun; 5:(12):259. https://doi.org/10.21037/atm.2017.03.99
    [Google Scholar]
  15. Ding J, Davis-Plourde KL, Sedaghat S, Tully PJ, Wang W, Phillips C, et al. Antihypertensive medications and risk for incident dementia and Alzheimer’s disease: a meta-analysis of individual participant data from prospective cohort studies. Lancet Neurol. 2020 Jan; 19:(1):61–70. https://doi.org/10.1016/S1474-4422(19)30393-X
    [Google Scholar]
  16. Sun D, Thomas EA, Launer LJ, Sidney S, Yaffe K, Fornage M. Association of blood pressure with cognitive function at midlife: a Mendelian randomization study. BMC Med Genomics. 2020 Aug; 13:(1):121. https://doi.org/10.1186/s12920-020-00769-y
    [Google Scholar]
  17. de Heus RAA, Olde Rikkert MGM, Tully PJ, Lawlor BA, Claassen JAHR; NILVAD Study Group. Blood pressure variability and progression of clinical Alzheimer disease. Hypertension. 2019 Nov; 74:(5):1172–80. https://doi.org/10.1161/HYPERTENSIONAHA.119.13664
    [Google Scholar]
  18. Wei J, Yin X, Liu Q, Tan L, Jia C. Association between hypertension and cognitive function: a cross-sectional study in people over 45 years old in China. J Clin Hypertens (Greenwich). 2018 Nov; 20:(11):1575–83. https://doi.org/10.1111/jch.13393
    [Google Scholar]
  19. Rouch L, Cestac P, Hanon O, Cool C, Helmer C, Bouhanick B, et al. Antihypertensive drugs, prevention of cognitive decline and dementia: a systematic review of observational studies, randomized controlled trials and meta-analyses, with discussion of potential mechanisms. CNS Drugs. 2015 Feb; 29:(2):113–30. https://doi.org/10.1007/s40263-015-0230-6
    [Google Scholar]
  20. Abell JG, Kivimäki M, Dugravot A, Tabak AG, Fayosse A, Shipley M, et al. Association between systolic blood pressure and dementia in the Whitehall II cohort study: role of age, duration, and threshold used to define hypertension. Eur Heart J. 2018 Sep; 39:(33):3119–125. https://doi.org/10.1093/eurheartj/ehy288
    [Google Scholar]
  21. Starr JM, Whalley LJ, Deary IJ. The effects of antihypertensive treatment on cognitive function: results from the HOPE study. J Am Geriatr Soc. 1996 Apr; 44:(4):411–5. https://doi.org/10.1111/j.1532-5415.1996.tb06412.x
    [Google Scholar]
  22. Chiu WC, Ho WC, Lin MH, Lee HH, Yeh YC, Wang JD, et al. Angiotensin receptor blockers reduce the risk of dementia. J Hypertens. 2014; 32:(4):938–47. https://doi.org/10.1097/HJH.0000000000000086
    [Google Scholar]
  23. Goh KL, Bhaskaran K, Minassian C, Evans SJ, Smeeth L, Douglas IJ. Angiotensin receptor blockers and risk of dementia: cohort study in UK Clinical Practice Research Datalink. Br J Clin Pharmacol. 2015 Feb; 79:(2):337–50. https://doi.org/10.1111/bcp.12511
    [Google Scholar]
  24. Gelber RP, Ross GW, Petrovitch H, Masaki KH, Launer LJ, White LR. Antihypertensive medication use and risk of cognitive impairment: the Honolulu-Asia Aging Study. Neurology. 2013 Sep; 81:(10):888–95. https://doi.org/10.1212/WNL.0b013e3182a351d4
    [Google Scholar]
/content/journals/10.5339/qmj.2025.106
Loading
Correlation of cognitive functions of hypertensive patients on different classes of antihypertensive drugs
Qatar Medical Journal 2025, 106 (2025); https://doi.org/10.5339/qmj.2025.106
/content/journals/10.5339/qmj.2025.106
/content/journals/10.5339/qmj.2025.106
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): angiotensin receptor blockers, antihypertensive drugs, calcium channel blockers, cognition and hypertension

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error