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Protection from Dementia

Stroke patients who take two common blood pressure medications are less likely to suffer dementia or cognitive decline if they have another stroke, finds a new study in this month’s Archives of Internal Medicine.
Dementia is a major health concern in developed nations, ranking as the eighth leading cause of death and disability. Studies have shown elevated blood pressure levels and prior incidence of stroke put people// at especially high risk for these mind-robbing conditions, but doctors are unsure whether treatment of high blood pressure can reduce the risk. Three large studies offered conflicting results: One suggested blood pressure treatment could reduce the risk for dementia but not cognitive decline, a second came out with the opposite finding, and a third showed a beneficial effect but included only a small number of dementia cases.

These researchers conducted a randomized, double-blind, placebo-controlled trial involving around 6,100 people with prior stroke or mini-stroke. About half the group received an ACE inhibitor, a blood pressure drug, and some also received a diuretic. The other half received a placebo. Participants were followed for around four years.

Results showed no clear-cut effect of the active treatment on the overall risk of dementia, but the risk of developing dementia with recurrent stroke was lowered by about a third in those who took the blood pressure medications. The overall risk of developing cognitive decline decreased by about a fifth in the treated group, and the risk of developing cognitive decline with recurrent stroke dropped by a half.

The investigators believe these findings support recommendations calling for all stroke patients to receive treatment with blood pressure lowering drugs.

SOURCE: Archives of Internal Medicine, 2003;163:1069-1075

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