ArticleBMJ open2013
Effects of centrally acting ACE inhibitors on the rate of cognitive decline in dementia.
Article in BMJ open, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis 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
42 citing papers in PubMed, 1 synthesis or guideline pooled it, 86 citations in OpenAlex.
- Clinical outcomes of antihypertensive medication use in people with dementia: a systematic review and meta-analysis.GeroScience · 2026Pooled it
- The Correlation between Two Angiotensin-Converting Enzyme Inhibitor's Concentrations and Cognition.International journal of environmental research and public health · 2022Trial
- Effect of the Casein-Derived Peptide Met-Lys-Pro on Cognitive Function in Community-Dwelling Adults Without Dementia: A Randomized, Double-Blind, Placebo-Controlled Trial.Clinical interventions in aging · 2020Trial
- Exploring prodrug approaches for Alzheimer's treatment: an overview.Neurodegenerative disease management · 2026Review
- Article
- Role of Angiotensin-Converting Enzyme in Cognitive Aging: Evidence from Preclinical and Clinical Studies.Frontiers in drug discovery · 2026Article
- Mid-life antihypertensive initiation and incident dementia: a machine learning-weighted target trial emulation in the health and retirement study.American journal of cardiovascular disease · 2026Article
- The heart-brain axis: neurocognitive frailty in heart failure.Journal of neurology · 2025Review
- Immunomodulatory Effects of RAAS Inhibitors: Beyond Hypertension and Heart Failure.Biomedicines · 2025Review
- Expression of SARS-CoV-2 entry receptor ACE2 in human brain and its association with Alzheimer's disease and COVID-19.Molecular psychiatry · 2025Review
- Captopril attenuates oxidative stress and neuroinflammation implicated in cisplatin-induced cognitive deficits in rats.Psychopharmacology · 2025Article
- Analysis of postmarketing neuropsychiatric adverse events of avapritinib based on the FDA adverse event reporting system.Scientific reports · 2025Article
- ACE1 does not influence cerebral Aβ degradation or amyloid plaque accumulation in 5XFAD mice.PloS one · 2025Article
- Antihypertensive medications and dementia in older adults with hypertension.medRxiv : the preprint server for health sciences · 2024Article
- Review
- Utilizing Proteomic Approaches to Uncover the Neuroprotective Effects of ACE Inhibitors: Implications for Alzheimer's Disease Treatment.Molecules (Basel, Switzerland) · 2023Article
- Deciphering mechanisms of action of ACE inhibitors in neurodegeneration usingFrontiers in neuroscience · 2023Review
- Impact of the Renin-Angiotensin System on the Pathogeny and Pharmacotherapeutics of Neurodegenerative Diseases.Biomolecules · 2022Review
- Observational
- Involvement of the Renin-Angiotensin System in Stress: State of the Art and Research Perspectives.Current neuropharmacology · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThere is growing evidence that antihypertensive agents, particularly centrally acting ACE inhibitors (CACE-Is), which cross the blood-brain barrier, are associated with a reduced rate of cognitive decline. Given this, we compared the rates of cognitive decline in clinic patients with dementia receiving CACE-Is (CACE-I) with those not currently treated with CACE-Is (NoCACE-I), and with those who started CACE-Is, during their first 6 months of treatment (NewCACE-I).
designObservational case-control study.
setting2 university hospital memory clinics.
participants817 patients diagnosed with Alzheimer's disease, vascular or mixed dementia. Of these, 361 with valid cognitive scores were included for analysis, 85 CACE-I and 276 NoCACE-I. MEASUREMENTS: Patients were included if the baseline and end-point (standardised at 6 months apart) Standardised Mini-Mental State Examination (SMMSE) or Quick Mild Cognitive Impairment (Qmci) scores were available. Patients with comorbid depression or other dementia subtypes were excluded. The average 6-month rates of change in scores were compared between CACE-I, NoCACE-I and NewCACE-I patients.
resultsWhen the rate of decline was compared between groups, there was a significant difference in the median, 6-month rate of decline in Qmci scores between CACE-I (1.8 points) and NoCACE-I (2.1 points) patients (p=0.049), with similar, non-significant changes in SMMSE. Median SMMSE scores improved by 1.2 points in the first 6 months of CACE treatment (NewCACE-I), compared to a 0.8 point decline for the CACE-I (p=0.003) group and a 1 point decline for the NoCACE-I (p=0.001) group over the same period. Multivariate analysis, controlling for baseline characteristics, showed significant differences in the rates of decline, in SMMSE, between the three groups, p=0.002.
conclusionsCognitive scores may improve in the first 6 months after CACE-I treatment and use of CACE-Is is associated with a reduced rate of cognitive decline in patients with dementia.
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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.