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The other day, I was thinking. Today, I am also thinking. In the future, I hope to continue thinking.
My goal to continue thinking clearly is one of the reasons I am very interested in studies about how to minimize the development and/or progression of Alzheimer’s disease and other dementias, which rob their victims of memories and thinking abilities.
This month, a group of researchers from Boston University School of Medicine published a study in the British Medical Journal telling us that there may be a way to decrease Alzheimer’s disease.
They found that angiotensin receptor blockers (ARBs), a particular class of blood pressure control medicines, are associated with a striking decrease in the occurrence and progression of dementia.
Using data from the Decision Support System Database of the U.S. Department of Veterans Affairs (with information on more than five million people) they looked at records from patients who used ARBs, and compared them with people who had a similar health status, but were taking different medications.
They found that patients taking ARBs had up to a 50 percent lower chance of getting Alzheimer’s disease or dementia. Patients taking two forms of medications that affect the angiotensin system, ARBs and Angiotensin Converting Enzyme (ACE) inhibitors, had a 55 percent lower risk of dementia.
People who were already suffering from Alzheimer’s disease or dementia had up to a 67 percent lower chance of being admitted to nursing homes or dying if they were taking both ARBs and ACE inhibitors.
Patients who appeared to benefit particularly well from use of ARBs were those who had experienced strokes before or during the course of their illness.
It is suggested that those who already have dementia might use ARBs to delay deterioration of brain function and help keep patients out of nursing homes. It appears that ARBs are more effective than other blood pressure and cardiovascular medicines for preventing Alzheimer’s disease or dementia.
Although the researchers are unsure why ARBs might be so beneficial, they believe one possibility suggested by prior studies on animal models is that ARBs help prevent nerve cell injury from blood vessel damage or help promote nerve cell recovery after blood vessel damage. The authors also speculate that ARBs might help protect the blood vessels in the brain against damage related to heart disease.
The ARB medicines include the following: losartan (Cozaar), candesartan (Atacand), valsartan (Diovan), irbesartan (Avapro), telmisartan (Micardis), eprosartan (Teveten), and olmesartan (Benicar).
In addition to their effect of dementia and their original use controlling high blood pressure, the ARBs (particularly candesartan) have been used for the treatment of heart failure in people who cannot tolerate ACE inhibitor therapy. Irbesartan and losartan have shown benefit in patients with both high blood pressure and type II diabetes, and may delay the progression of kidney damage due to diabetes. Candesartan is even used experimentally to try to prevent migraine headaches.
Along with all the good effects, there are some common side effects. These include dizziness, headache, and/or elevated potassium levels. Infrequently, they might cause blood pressure to drop too low when standing, rash, diarrhea, stomach upset, abnormal liver function, muscle cramps or pains, back pain, insomnia, anemia, kidney impairment, sore throat, and/or nasal congestion. The dry cough and/or facial or tongue swelling sometimes associated with ACE inhibitor therapy may rarely occur with ARBs.
Nobody is sure whether or not there is a slight increase in the risk of heart attack due to ARB use. Some studies have demonstrated that ARBs can increase that risk while other studies have found that they do not. Further investigations are underway.
For myself, I will continue to do everything I can to avoid needing to take blood pressure medicine by using exercise and salt avoidance as well as weight and stress control. However, the chance to avoid or delay dementia has moved ARBs much higher on my list of possible medicines if my blood pressure becomes too high.
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