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March 2013

Alzheimer Pathology and Angiotension Receptor Blockers

Author Affiliations

Author Affiliations: Departments of Medicine (Dr Hajjar and Ms Brown), Preventive Medicine (Dr Mack), and Neurology (Dr Chui), Division of Geriatric, Hospital, and General Internal Medicine, University of Southern California, Los Angeles, California.

JAMA Neurol. 2013;70(3):414. doi:10.1001/jamaneurol.2013.1689

In reply

We appreciate the interest Oprisiu et al expressed in our recent publication.1 We agree that a clinical trial comparing the cognitive effects of angiotensin-converting enzyme inhibitors with angiotensin receptor blockers (ARBs) in older adults with hypertension is critical. In this respect, we have recently completed a pilot study comparing lisinopril, candesartan, and an active control with hydrochlorothiazide.2 In this pilot trial, we found a superior positive effect of ARBs relative to angiotensin-converting enzyme inhibitors on cognitive function. We are planning a larger trial to confirm and extend these initial findings.

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