Angiotensin -II stimulating antihypertensives markedly reduce dementia risk: Study
Angiotensin -II stimulating antihypertensives users had lower dementia rates compared to angiotensin-II inhibiting antihypertensive users, suggests the findings of a recent study. The interesting findings have recently been published in the Neurology.
Accumulating evidence suggests that some antihypertensive drug subclasses may reduce incident dementia beyond their effect on BP. The mechanisms underlying these differential effects are currently unclear. They may be related to the renin-angiotensin system . In the RAS, angiotensin-II lowers BP, mainly via activity at angiotensin type 1 (AT1) receptors. It also activates AT2 receptors and AT4 receptors, which have a number of associated effects (vasodilation, apoptosis). Hypothetically, the RAS also helps maintaining brain function. Angiotensin-II and -IV seem to protect against ischemia, especially through AT2, and preserve memory through AT4. Furthermore, angiotensin converting enzyme mediates amyloid-beta degradation in the brain.
Researchers undertook the preDIVA trial to assess whether angiotensin-II stimulating antihypertensives (thiazides, dihydropyridine calcium channel blockers, and angiotensin-1 receptor blockers) convey a lower risk of incident dementia compared to angiotensin-II inhibiting antihypertensives (angiotensin-converting enzyme inhibitors, beta blockers, and non-dihydropyridine calcium channel blockers), in accordance with the 'angiotensin hypothesis'.
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