Research Institute of Cardiology of Siberian Branch of Russian Academy of Medical Sciences, Tomsk, Russia
Background and Purpose: Cognitive impairment also arises at early stages of hypertension. Angiotensin receptor blocker (ARB) suppress activity of sympathetic nervous system and are capable to eliminate factors which raise vascular risk in hypertensive patients. The aim of the present study was to study hypotensive and ñerebroprotective efficacy of ARB irbesartan and losartan in hypertensive patients.
Methods: Forty five hypertensive patients (21 women and 24 men), aged between 28–56 years, were randomized to treatment with either blockers irbesartan 150–300 mg or losartan 50–100 mg during 6 month. 24-hours ambulatory blood pressure monitoring and neurocognitive assessment by Wechsler Memory Scale (WMS) were performed in all patients at baseline and in course of the treatment.
Results: Irbesartan reduced significantly 24-h SBP (with 156.8 mm Hg up to 134.0 mm Hg; P = 0.009), 24-h DBP (with 96 mm Hg up to 88 mm Hg; P = 0.012), time-index 24-h SBP (with 72% up to 44%; P = 0.014) and time-index 24-h DBP (with 64% up to 42%; P = 0.018). Losartan reduced significantly 24-h SBP (with 148.8 mm Hg up to 132.0 mm Hg; P = 0.008), 24-h DBP (with 98 mm Hg up to 89 mm Hg; P = 0.024), time-index 24-h SBP (with 58% up to 42%; P = 0.028) and time-index 24-h DBP (with 46% up to 38%; P = 0.034). Later 6 months hypotensive therapies by results of proof test were marked statistically significant reduction the quantity of errors (irbesartan with 6 up to 1.8; P = 0.003, losartan with 5 up to 4.2; P = 0.062). By results of tables of Shulte psychomotor speed has increased (irbesartan with 48 sec up to 36 sec; P = 0.026, losartan with 48 sec up to 44 sec; P = 0.242), indicators of long-term memory have increased (irbesartan with 68.5 word up to 52.6 word; P = 0.005, losartan with 60.4 word up to 56.2 word; P = 0.084).
Conclusions: Our study demonstrates, that long controllable treatment of hypertension with irbesartan and losartan reduces blood pressure and improves cognitive function. The most expressed positive effect on cognition rendered irbesartan.