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血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂通过控制高血压在保护认知功能方面的作用:重要更新

The role of ACE inhibitors and ARBs in preserving cognitive function via hypertension Management: A critical Update.

作者信息

Yasmin Sabina, Ashique Sumel, Taj Tahreen, Garg Ashish, Das Joy, Shorog Eman, Bhui Utpal, Pal Radheshyam, Selim Samy, Panigrahy Uttam Prasad, Begum Naseem, Islam Anas, Ansari Mohammad Yousuf

机构信息

Department of Pharmaceutical Chemistry, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia.

School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab 144411, India.

出版信息

Brain Res. 2025 Mar 1;1850:149400. doi: 10.1016/j.brainres.2024.149400. Epub 2024 Dec 15.

Abstract

Hypertension poses a significant risk to cognition-related disorders like dementia. As the global population ages, age-related neurological illnesses such as Alzheimer's disease are becoming increasingly prevalent. The primary hypertension treatments, angiotensin receptor blockers, and angiotensin-converting enzyme inhibitors, exhibit neuroprotective properties. However, observational studies suggest that they may independently contribute to cognitive decline and dementia. Some of these medications have shown promise in reducing cognitive impairment and amyloid buildup in Alzheimer's models. While direct comparisons between the two drug classes are limited, angiotensin receptor blockers have been associated with less brain shrinkage, lower dementia incidence, and slower cognitive decline compared to angiotensin-converting enzyme inhibitors. Both types of medications can influence cognition by passing the blood-brain barrier, with angiotensin receptor blockers potentially offering superior neuroprotective effects due to their selective blockade of the angiotensin type 1 receptor.

摘要

高血压对痴呆等认知相关疾病构成重大风险。随着全球人口老龄化,阿尔茨海默病等与年龄相关的神经疾病日益普遍。主要的高血压治疗药物,即血管紧张素受体阻滞剂和血管紧张素转换酶抑制剂,具有神经保护特性。然而,观察性研究表明,它们可能独立导致认知衰退和痴呆。其中一些药物在减少阿尔茨海默病模型中的认知障碍和淀粉样蛋白积累方面显示出前景。虽然这两类药物之间的直接比较有限,但与血管紧张素转换酶抑制剂相比,血管紧张素受体阻滞剂与较少的脑萎缩、较低的痴呆发病率和较慢的认知衰退有关。这两类药物都可以通过血脑屏障影响认知,血管紧张素受体阻滞剂由于其对1型血管紧张素受体的选择性阻断,可能具有更好的神经保护作用。

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