Antihypertensive therapy and cerebral hemodynamics in executive mild cognitive impairment: results of a pilot randomized clinical trial.

Author(s): Hajjar I(1), Hart M, Chen YL, Mack W, Novak V, C Chui H, Lipsitz L.

Affiliation(s): Author information: (1)Division of Geriatric, Hospital, and General Internal Medicine, Department of Medicine, University of Southern California, Los Angeles, CA 90033, USA. ihajjar@usc

Publication date & source: 2013, J Am Geriatr Soc. , 61(2):194-201

OBJECTIVES: To compare the effects of three antihypertensive medications on cerebral hemodynamic and cognitive function in hypertensive individuals with executive dysfunction. DESIGN: Double-blind randomized clinical trial. SETTING: Community. PARTICIPANTS: Fifty-three individuals aged 60 and older with hypertension and executive dysfunction. INTERVENTION: Lisinopril, candesartan, or hydrochlorothiazide for 1 year. MEASUREMENTS: Cerebral blood flow velocity (BFV; transcranial Doppler ultrasonography during rest, sitting, standing, hypercapnia, and hypocapnia), cognition, and blood pressure were measured at baseline and after 6 and 12 months. Linear mixed models were used to compare the three groups. RESULTS: Of the 53 participants, 47 had successful insonation (mean age 72; 70% white; 57% women). There was a tendency toward an increase in BFV in the candesartan group and a decrease in the lisinopril and hydrochlorothiazide groups (between-group P = .57) that was significant in those with low BFV at baseline (