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Which Blood Pressure Pills Help Protect Memory?

ACE inhibitors that can get into the brain may protect memory in older adults. ARBs that cross the blood-brain barrier also seem to work.
Which Blood Pressure Pills Help Protect Memory?
Man check blood pressure. Self care heart rate monitoring with digital pressure gauge.

High blood pressure is a risk factor for dementia as people age. However, people who take certain blood pressure medicines that cross the blood-brain barrier might be able to protect memory and cognitive function.

Blood Pressure Pills That Protect Memory:

An analysis of 14 randomized controlled trials with 12,900 volunteers compared people on specific ACE inhibitor blood pressure pills to those on other medications that don’t get into the brain (Hypertension, June 21, 2021). (ACE stands for Angiotensin Converting Enzyme.) The medications are captopril, fosinopril, lisinopril, perindopril and ramipril. People on these drugs had smaller declines in their scores on memory tests from year to year.

In addition to the ACE inhibitor medicines, the ARBs telmisartan and candesartan also cross the blood-brain barrier. (ARBs are Angiotensin II Receptor Blockers.) They too were associated with a slower decline in memory performance. The senior author, Dr. Daniel Nation, has suggested that the effect may be independent of blood pressure control. Of course, controlling blood pressure is very valuable. However, these drugs that act on the renin-angiotensin system may be affecting the brain’s own renin-angiotensin system as well as the body’s.

Varied Effects on Cognitive Performance:

While older individuals taking the drugs that cross the blood-brain barrier scored higher on tests of memory, those taking different types of drugs scored better on attention. However, the two groups of volunteers did not show systematic differences on other cognitive scores, including language and learning.

Do Drugs that Protect Memory Prevent Dementia?

The big question is whether these drugs can help prevent dementia. No one has a clear answer to that yet. On the other hand, experts agree that blood pressure control is as important for the brain as the heart. Ultimately, medications that get into the brain may be better able to protect memory.

Learn More:

To find out more about blood pressure medicines, including ACE inhibitors and ARBs, you may want to read our eGuide to Blood Pressure Solutions. Beyond medications, this online resource also covers food, herbs and other non-drug approaches.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
  • Ho JK et al, "Blood-brain barrier crossing renin-angiotensin drugs and cognition in the elderly: A meta-analysis." Hypertension, June 21, 2021. DOI: 10.1161/HYPERTENSIONAHA.121.17049
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