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ACE inhibitors & dementia

ACE inhibitors as a class do not appear to be independently associated with cognitive decline in the elderly. However, there may be an association if the data is examined after separating centrally-active ACE inhibitors (captopril, fosinopril, lisinopril, perindopril, ramipril, & trandolapril) which cross the blood-brain barrier from those that do not (benazepril, enalapril, moexipril, & quinapril do not). Centrally-active ACE inhibitors appear to slow cognitive impairment & non centrally-active agents appear to accelerate it. Further confirmation needed [1].

References

  1. Sink KM et al Angiotensin-Converting Enzyme Inhibitors and Cognitive Decline in Older Adults With Hypertension: Results From the Cardiovascular Health Study Arch Intern Med. 2009;169(13):1195-1202 PMID: 19597068