Anti-hypertensive agents in Alzheimer's disease: beyond vascular protection.

Anti-hypertensive agents in Alzheimer's disease: beyond vascular protection. Expert Rev Neurother. 2019 Dec 23;: Authors: Lebouvier T, Chen Y, Duriez P, Pasquier F, Bordet R Abstract INTRODUCTIONMidlife hypertension has been consistently linked with increased risk of cognitive decline and Alzheimer's disease (AD). Observational studies and randomized trials show that the use of antihypertensive therapy is associated with a lesser incidence or prevalence of cognitive impairment and dementia. However, whether anti-hypertensive agents specifically target the pathological process of AD remains elusive.AREAS COVEREDThis review of literature provides an update on the clinical and preclinical arguments supporting anti-AD properties of antihypertensive drugs. The authors focused on validated all classes of antihypertensive treatments such as angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), calcium channel blockers (CCB), β-blockers, diuretics, neprilysin inhibitors, and other agents. Three main mechanisms can be advocated: action on the concurrent vascular pathology, action on the vascular component of Alzheimer's pathophysiology, and action on non-vascular targets.EXPERT OPINIONIn 2019, while there is no doubt that hypertension should be treated in primary prevention of vascular disease and in secondary prevention of stroke and mixed dementia, the place of antihypertensive agents in the secondary prevention of "pure" AD rem...
Source: Expert Review of Neurotherapeutics - Category: Neurology Tags: Expert Rev Neurother Source Type: research