Trial reportJournal of the American Geriatrics Society2013
Antihypertensive therapy and cerebral hemodynamics in executive mild cognitive impairment: results of a pilot randomized clinical trial.
Trial report in Journal of the American Geriatrics Society, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 5 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Effects of candesartan on cerebral microvascular function in mild cognitive impairment: Results of two clinical trials.International journal of stroke : official journal of the International Stroke Society · 2023Pooled it
- Effect of Antihypertensive Treatment on Cerebral Blood Flow in Older Adults: a Systematic Review and Meta-Analysis.Hypertension (Dallas, Tex. : 1979) · 2022Pooled it
- Pharmacological treatment of hypertension in people without prior cerebrovascular disease for the prevention of cognitive impairment and dementia.The Cochrane database of systematic reviews · 2021Pooled it
- Effects of vasodilating medications on cerebral haemodynamics in health and disease: systematic review and meta-analysis.Journal of hypertension · 2019Pooled it
- First-line drugs inhibiting the renin angiotensin system versus other first-line antihypertensive drug classes for hypertension.The Cochrane database of systematic reviews · 2018Pooled it
- Effects of Candesartan vs Lisinopril on Neurocognitive Function in Older Adults With Executive Mild Cognitive Impairment: A Randomized Clinical Trial.JAMA network open · 2020Trial
- The effect of adjunctive telmisartan treatment on psychopathology and cognition in patients with schizophrenia.Acta psychiatrica Scandinavica · 2017Trial
- Aldosterone, cognitive function, and cerebral hemodynamics in hypertension and antihypertensive therapy.American journal of hypertension · 2015Trial
- Cerebrovascular carbon dioxide reactivity is intact in chronic kidney disease.Physiological reports · 2024Article
- New Users of Angiotensin II Receptor Blocker-Versus Angiotensin-Converting Enzyme Inhibitor-Based Antihypertensive Medication Regimens and Cardiovascular Disease Events: A Secondary Analysis of ACCORD-BP and SPRINT.Journal of the American Heart Association · 2023Article
- Biological Risk Factors Influencing Vascular Cognitive Impairments: A Review of the Evidence.Brain sciences · 2023Review
- First-line diuretics versus other classes of antihypertensive drugs for hypertension.The Cochrane database of systematic reviews · 2023Review
- RENEWAL: REpurposing study to find NEW compounds with Activity for Lewy body dementia-an international Delphi consensus.Alzheimer's research & therapy · 2022Review
- Migraine Pharmacological Treatment and Cognitive Impairment: Risks and Benefits.International journal of molecular sciences · 2022Review
- Effect of drug interventions on cerebral hemodynamics in ischemic stroke patients.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2022Review
- Safety and biomarker effects of candesartan in non-hypertensive adults with prodromal Alzheimer's disease.Brain communications · 2022Article
- Brain Renin-Angiotensin System as Novel and Potential Therapeutic Target for Alzheimer's Disease.International journal of molecular sciences · 2021Review
- Effects of Antihypertensive Drugs on Cognitive Function in Elderly Patients with Hypertension: A Review.Aging and disease · 2021Review
- The Utility of Cerebrovascular Reactivity MRI in Brain Rehabilitation: A Mechanistic Perspective.Frontiers in physiology · 2021Review
- Cerebral blood flow is reduced in ME/CFS during head-up tilt testing even in the absence of hypotension or tachycardia: A quantitative, controlled study using Doppler echography.Clinical neurophysiology practice · 2020Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesTo compare the effects of three antihypertensive medications on cerebral hemodynamic and cognitive function in hypertensive individuals with executive dysfunction.
designDouble-blind randomized clinical trial.
settingCommunity.
participantsFifty-three individuals aged 60 and older with hypertension and executive dysfunction.
interventionLisinopril, candesartan, or hydrochlorothiazide for 1 year. MEASUREMENTS: Cerebral blood flow velocity (BFV; transcranial Doppler ultrasonography during rest, sitting, standing, hypercapnia, and hypocapnia), cognition, and blood pressure were measured at baseline and after 6 and 12 months. Linear mixed models were used to compare the three groups.
resultsOf the 53 participants, 47 had successful insonation (mean age 72; 70% white; 57% women). There was a tendency toward an increase in BFV in the candesartan group and a decrease in the lisinopril and hydrochlorothiazide groups (between-group P = .57) that was significant in those with low BFV at baseline (<median 27.6 cm/s, between-group P = .03). The candesartan group also had the greatest improvement in executive function (Trail Making Test Part B improved by 17.1 seconds, vs hydrochlorothiazide improved by 4.2 seconds and lisinopril worsened by 14.4 seconds, P = .008). Carbon dioxide vasoreactivity and vasomotor range declined significantly in the lisinopril (within-group P = .001 for vasoreactivity and .02 for vasomotor range) and hydrochlorothiazide groups (within-group P = .10 and .009, respectively) but not in the candesartan group (within-group P = .25 and .38, respectively; between-group P = .30 and .46, respectively).
conclusionAngiotensin receptor blockers may preferentially preserve cerebral hemodynamics and executive function in individuals with executive dysfunction. These findings warrant further investigation in a larger trial.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.