Angiotensin Receptor Blockers and Cognition: a Scoping Review

Zhen Zhou; Suzanne G Orchard; Mark R Nelson; Michelle A Fravel; Michael E Ernst

doi:10.1007/s11906-023-01266-0

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Angiotensin Receptor Blockers and Cognition: a Scoping Review

Journal article

Open access

Peer reviewed

Angiotensin Receptor Blockers and Cognition: a Scoping Review

Zhen Zhou, Suzanne G Orchard, Mark R Nelson, Michelle A Fravel and Michael E Ernst

Current hypertension reports, Vol.26(1), pp.1-19

01/2024

DOI: 10.1007/s11906-023-01266-0

PMCID: PMC10796582

PMID: 37733162

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Abstract

PURPOSE OF REVIEW To provide an overview of the association between angiotensin II receptor blocker (ARB) use and cognitive outcomes. RECENT FINDINGS ARBs have previously shown greater neuroprotection compared to other anti-hypertensive classes. The benefits are primarily attributed to the ARB's effect on modulating the renin-angiotensin system via inhibiting the Ang II/AT1R pathway and activating the Ang II/AT2R, Ang IV/AT4R, and Ang-(1-7)/MasR pathways. These interactions are associated with pleiotropic neurocognitive benefits, including reduced β-amyloid accumulation and abnormal hyperphosphorylation of tau, ameliorated brain hypo-fusion, reduced neuroinflammation and synaptic dysfunction, better neurotoxin clearing, and blood-brain barrier function restoration. While ACEis also inhibit AT1R, they simultaneously lower Ang II and block the Ang II/AT2R and Ang IV/AT4R pathways that counterbalance the potential benefits. ARBs may be considered an adjunctive approach for neuroprotection. This preliminary evidence, coupled with their underlying mechanistic pathways, emphasizes the need for future long-term randomized trials to yield more definitive results.

Details

Title: Subtitle: Angiotensin Receptor Blockers and Cognition: a Scoping Review
Creators: Zhen Zhou - Monash University
Suzanne G Orchard - Monash University
Mark R Nelson - University of Tasmania
Michelle A Fravel - University of Iowa
Michael E Ernst - University of Iowa
Resource Type: Journal article
Publication Details: Current hypertension reports, Vol.26(1), pp.1-19
DOI: 10.1007/s11906-023-01266-0
PMID: 37733162
PMCID: PMC10796582
NLM abbreviation: Curr Hypertens Rep
ISSN: 1522-6417
eISSN: 1534-3111
Grant note: DOI: 10.13039/501100001779, name: Monash University
Language: English
Electronic publication date: 09/21/2023
Date published: 01/2024
Academic Unit: Family and Community Medicine; Pharmacy Practice and Science
Record Identifier: 9984466699602771

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