Influence of losartan and atenolol on memory function in very elderly hypertensive patients
Influence of losartan and atenolol on memory function in very elderly hypertensive patients
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DOI：
10.1038/sj.jhh.1001613
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发表时间：
2003-11-01
影响因子：
2.7
通讯作者：
Preti, P
中科院分区：
文献类型：
--
作者：
Fogari, R;Mugellini, A;Preti, P
本研究的目的是比较-肾上腺素能阻滞剂阿替洛尔和血管紧张素II型1 （AT1）受体拮抗剂氯沙坦对老年高血压患者认知功能的影响。研究对象为120例轻度至中度原发性高血压（DBP 490和< 105 mmHg）患者，年龄75-89岁。在4周的安慰剂洗脱期后，根据平行对照设计，他们随机接受阿替洛尔50毫克或氯沙坦50毫克，持续24周。在安慰剂期和每个积极治疗期结束时，测量血压（通过水银血压计，Korotkoff I和V），并通过三个不同的测试（单词表记忆，单词表回忆和单词表流畅性）评估认知功能。阿替洛尔和氯沙坦在降低收缩压（分别为-22.1和-23.1 mmHg，与基线相比P < 0.01）和舒张压（分别为-10.3和-11.2 mmHg，与基线相比P < 0.01）方面同样有效。阿替洛尔治疗未引起任何测试分数的显著变化，而氯沙坦显著提高了单词列表记忆（+2.2,P < 0.05）和单词列表回忆测试（+2.1,P < 0.05）。氯沙坦与阿替洛尔在两项记忆测试中的差异均有统计学意义（P < 0.05）。这些数据表明，在高龄高血压患者中，氯沙坦慢性AT1受体阻断可以改善认知功能，特别是即时和延迟记忆。
The aim of this study was to compare the effect of the beta-adrenergic blocker atenolol and the Angiotensin II type 1 (AT1) receptor antagonist losartan on cognitive function in very elderly hypertensive patients. A total of 120 mild to moderate essential hypertensive (DBP 490 and < 105 mmHg) patients, aged 75-89 years, were studied. After a 4-week wash-out period on placebo, they were randomized to receive atenolol 50 mg or losartan 50 mg for 24 weeks according to a parallel arm design. At the end of the placebo period and of each active treatment period, BP was measured (by mercury sphygmomanometer, Korotkoff I and V) and cognitive function was evaluated through three different tests (word list memory, word list recall and word list fluency). Both atenolol and losartan were equally effective in reducing SBP (-22.1 and -23.1 mmHg, respectively, P < 0.01 vs baseline) and DBP (-10.3 and -11.2 mmHg, respectively, P < 0.01 vs baseline). Atenolol treatment did not induce significant changes in any test score, whereas losartan significantly increased the score of both the word list memory (+2.2, P < 0.05 vs baseline) and the word list recall test (+2.1, P < 0.05 vs baseline). The comparison between losartan and atenolol was significant (P < 0.05) for both memory tests. These data suggest that in very elderly hypertensive patients, chronic AT1 receptor blockade by losartan could improve cognitive function, in particular immediate and delayed memory.