Tisaire-Sánchez J, Roma J, Camacho-Azcargorta Ignacio, Bueno-Gómez J, Mora-Maciá J, Navarro Angel
Fundación para la Investigación de la Hipertensión Arterial, Zaragoza, Spain.
Vasc Health Risk Manag. 2006;2(4):491-8. doi: 10.2147/vhrm.2006.2.4.491.
The aim of this longitudinal, open-label, comparative, multicenter study was to assess cognitive function in hypertensive patients receiving mid-term treatment with lercanidipine.
Hypertensive patients aged 40 years or older were treated with lercanidipine (10 mg daily) after 7-10 days washout period. The duration of the study was 6 months. Blood pressure (BP) was measured every 4 weeks (JNC 6th report). In patients with inadequate BP control, doxazosin was added and up-titrated. At baseline and after 6 months of treatment, cognitive function was evaluated using the Spanish validated version of the Mini-Mental State Examination (MMSE) and the Trail Making Test (TMT).
In the study population of 467 patients, BP decreased from 154.4/95.3 mmHg at baseline to 134.8/80.7 mmHg at 6 months. At the end of the study, 98% of patients were receiving lercanidipine, 20% an angiotensin-converting enzyme inhibitor, and 6% doxazosin. Adequate BP control was obtained in 68% of patients. The mean (standard deviation) MMSE scores improved from 32.35 (2.59) to 33.25 (2.36) (p < 0.0001). Patients with good BP control scored significantly better than those with inadequate BP control (p < 0.05), which was already observed at the first month.
The third-generation calcium channel antagonist, lercanidipine, improved cognitive function after 6 months of treatment especially in patients with good BP control, suggesting that improvements in cognitive function may be associated with a decrease in BP.
本纵向、开放标签、对照、多中心研究旨在评估接受乐卡地平中期治疗的高血压患者的认知功能。
年龄在40岁及以上的高血压患者在经过7 - 10天的洗脱期后接受乐卡地平治疗（每日10毫克）。研究持续时间为6个月。每4周测量一次血压（依据美国国家联合委员会第6次报告）。血压控制不佳的患者加用多沙唑嗪并逐步增加剂量。在基线期和治疗6个月后，使用西班牙验证版的简易精神状态检查表（MMSE）和连线测验（TMT）评估认知功能。
在467例研究人群中，血压从基线时的154.4/95.3毫米汞柱降至6个月时的134.8/80.7毫米汞柱。在研究结束时，98%的患者接受乐卡地平治疗，20%接受血管紧张素转换酶抑制剂治疗，6%接受多沙唑嗪治疗。68%的患者血压得到充分控制。MMSE平均（标准差）评分从32.35（2.59）提高到33.25（2.36）（p < 0.0001）。血压控制良好的患者得分显著高于血压控制不佳的患者（p < 0.05），这在第一个月时就已观察到。
第三代钙通道拮抗剂乐卡地平在治疗6个月后改善了认知功能，尤其是在血压控制良好的患者中，这表明认知功能的改善可能与血压降低有关。
