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Medical English / 10. 8. 2009

Thinking Clearly about ACE inhibitors / By Tom Secrest

Cognitive decline; the words are simple, but not the consequences. Today new technologies, medicines and treatments can increase the quantity of life, but sometimes the extended life spans come with something few people anticipate, i.e. cognitive decline. Patients are exercising, eating healthy all in an effort to enjoy longer, healthier lives. For some, the price of a healthier body and a longer life is that their mind goes before they do.

However, a new study (July 13, 2009; Archives of Internal Medicine), reveals that there is drug that might serve a dual purpose. The report looked at the effects of antihypertensive treatment on (i) risk of dementia, (ii) cognitive function scores, and (iii) disability associated with instrumental activities of daily living.

Overall the study found no effects of antihypertensive treatment on the above-mentioned measures of cognitive decline. However as they analyzed their data further, they found that there was a difference between those treated with centrally acting ACE inhibitors and other forms of antihypertensive treatment. What they found was that those taking centrally acting ACE inhibitors showed 65% less decline in cognitive function scores for each year of use. Oddly enough, non-centrally acting ACE inhibitors seemed to be linked to an increase risk of cognitive decline, compared with other antihypertensive medications.

Dr. Kaycee M. Sink (Wake Forest University School of Medicine) said that the reduction in cognitive decline did not seem to be linked to the antihypertensive effects of the centrally acting ACE inhibitors. Instead Dr. Link’s team believe that the benefits stem from their direct effects on the brain’s own renin-angiotensin system, which is involved with both memory and cognition. Additionally, suppression of the brain’s renin-angiotensin system may also mitigate the production of inflammatory cytokines, a number of which have been implicated in degenerative dementias.

Deciding which antihypertensive medication to prescribe or take will, of course, have to be evaluated on a case by case basis, but for cases where a centrally active ACE inhibitor appears to be as good a choice as any of several other drugs, the decision becomes, pardon the pun, a “no-brainer.”


  • thinking about – zamyšlení nad
  • cognitive decline – úbytek kognitivních funkcí
  • consequences – důsledky, následky
  • life span – délka života
  • effort – snaha, úsilí
  • purpose – cíl, smysl, záměr
  • above-mentioned – výše uvedený
  • oddly –  kupodivu
  • seem – pravděpodobně, patrně
  • additionally – dodatečně, navíc
  • to mitigate – zmírňovat, snižovat
  • inflammatory – zánětlivý
  • implicated – zapletený do
  • deciding – při rozhodování
  • pun – slovní hříčka

                                                                                 About Tom Secrest / Tom Secrest online 



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