Statins, ARBs, Do Not Affect Cognitive Decline Risk

Long-term blood pressure lowering therapy with a statin and an angiotensin-receptor blocker does not slow cognitive decline in older patients, according to a recent analysis.

In order to examine the effects of treatment with candesartan/hydrochlorothiazide, rosuvastatin, or their combination on rates of cognitive decline in older patients with intermediate cardiovascular risk, researchers conductee the Heart Outcomes Prevention Evaluation-3 (HOPE-3) study, a double-blind, randomized, placebo-controlled clinical trial.

Participants (n=2361) with intermediate cardiovascular risk but without cardiovascular disease were randomly assigned to receive candesartan (16 mg) plus hydrochlorothiazide (12.5 mg) or placebo and to rosuvastatin (10 mg) or placebo. Those who were aged 70 years or older also completed the Digit Symbol Substitution Test (DSST), the modified Montreal Cognitive Assessment, and the Trail Making Test Part B at baseline and at the end of the study.
 

Overall, 1626 of the participants completed both baseline and study-end assessments. The mean difference in DSST scores was −0.91 for candesartan/hydrochlorothiazide, −0.54 for rosuvastatin, and −1.43 for combination therapy compared with placebo.

“Long-term blood pressure lowering with candesartan plus hydrochlorothiazide, rosuvastatin, or their combination did not significantly affect cognitive decline in older people,” the researchers concluded.

—Michael Potts

Reference:

Bosch J, O’Donnel M, Swaminathan B, et al. Effects of blood pressure and lipid lowering on cognition [published online February 27, 2019]. Neurology. doi: https://doi.org/10.1212/WNL.0000000000007174.