We read with interest the article by Sink and colleagues1 describing an association between the use of centrally active ACEIs that can cross the BBB and a reduction in cognitive decline in a large, well-characterized cohort of treated older adults with hypertension. Using computerized information on patients in our university hospital, we also found that the long-term use of centrally active ACEIs (captopril or perindopril) is associated with a lower risk of incident dementia compared with other antihypertension drugs in elderly hypertensive patients.2 Furthermore, we found that the centrally active ACEIs significantly reduce the rate of cognitive decline in hypertensive patients with mild to moderate AD compared with other antihypertensive drugs, although all participants had a stable and comparable blood pressure.3
Asamura T, Ohrui T, Une K, Furukawa K, Arai H. Centrally Active ACEIs and Cognitive Decline. Arch Intern Med. 2010;170(1):107–108. doi:10.1001/archinternmed.2009.463
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