Premium
Antihypertensive Therapy and Cerebral Hemodynamics in Executive Mild Cognitive Impairment: Results of a Pilot Randomized Clinical Trial
Author(s) -
Hajjar Ihab,
Hart Meaghan,
Chen YuLing,
Mack Wendy,
Novak Vera,
C. Chui Helena,
Lipsitz Lewis
Publication year - 2013
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12100
Subject(s) - medicine , candesartan , hydrochlorothiazide , lisinopril , brain natriuretic peptide , hemodynamics , cardiology , pulse wave velocity , transcranial doppler , blood pressure , anesthesia , angiotensin ii , angiotensin converting enzyme , heart failure
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 (