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ASSESSMENT OF COGNITIVE FUNCTION IN PATIENTS WITH ESSENTIAL HYPERTENSION TREATED WITH LERCANIDIPINE

Abstract

The aim of this longitudinal, open-label, comparative, multi-centre study was to assess cognitive function in hypertensive patients receiving mid-term treatment with lercanidipine. Hypertensive patients aged 40 years or older were treated with lercanidipine (10 mg daily) after 7–10 days washout period. The duration of the study was 6 months. Blood pressure (BP) was measured every 4 weeks (JNC 6th report). In patients with inadequate BP control, doxazosin was added and up-titrated. At baseline and after 6 months of treatment, cognitive function was evaluated using the Spanish validated version of the Mini-Mental State Examination (MMSE) and the Trail Making Test (TMT). In the study population of 467 patients, BP decreased from 154,4/95,3 mmHg at baseline to 134,8/80,7 mmHg at 6 months. At the end of the study, 98% of patients were receiving lercanidipine, 20% – an angiotensin-converting enzyme inhibitor, and 6% – doxazosin. Adequate BP control was obtained in 68% of patients. The mean (standard deviation) MMSE scores improved from 32,35 (2,59) to 33,25 (2,36) (p<0,0001). Patients with good BP control scored significantly better than those with inadequate BP control (p<0,05), which was already observed at the first month. Conclusion: The third-generation calcium channel antagonist, lercanidipine, improved cognitive function after 6 months of treatment especially in patients with good BP control, suggesting that improvements in cognitive function may be associated with a decrease in BP.

About the Authors

J. Tisaire-Sánchez
Fundación para la Investigación de la Hipertensión Arterial, Сарагосса
Spain


J. Roma
Fundació per l’Estudi de la Hipertensió Arterial als Hospitals Comarcals de Catalunya
Spain


I. Camacho-Azcargorta
Servicio de Cardiología, Clínica San José
Spain


J. Bueno-Gómez
Fundación para la Investigación de la Hipertensión Arterial, Сарагосса
Spain


J. Mora-Maciá
Unidad de Hipertensión Arterial
Spain


Angel Navarro
Recordati España
Spain


References

1. Ameiling EH, de Korte DH, Man in’t Veld A. 1991. Impact of diagnosis and treatment of hypertension on quality of life: a doubleblind, randomized, placebo-controlled, cross-over study of beaxolol // J Cardiovasc Pharmacol, 18:752–60.

2. American Heart Association. 1999. Heart and Stroke Statistical Update. Dallas, Texas: American Heart Association. p 1–9.

3. Applegate WB, Pressels S, Wittes J, et al. 1994. Impact of the treatment of isolated systolic hypertension on behavioral variables: results from the systolic hypertension in the Elderly Program // Arch Intern Med, 154:2154–60.

4. Bang LM, Chapman TM, Goa KL. 2003. Lercanidipine. A review of its efficacy in the management of hypertension. Drugs, 63:2449–72.

5. Barrios V, Navarro A, Esteras A, et al for the Investigators of ELYPSE Study. 2002. Antihypertensive efficacy and tolerability of lercanidipine in daily clinical practice // The ELYPSE Study. Blood Press, 11:95–100.

6. Bird AS, Blizard RA, Mann HT. 1990.Treating hypertension in the older person: an evaluation of the association of blood pressure level and its reduction with cognitive performance // J Hypertens, 8:147–52.

7. Bulpitt CJ, Connor M, Schulte M, Fletcher AE. 2000. Bisoprolol and nifedipine retard in elderly hypertensive patients: effects on quality of life // J Hum Hypertens, 14:205–12.

8. Chamontin B, Poggi L, Lang T, et al. 1998. Prevalence, treatment, and control of hypertension in the French population: data from a survey on high blood pressure in general practice, 1994 // Am J Hypertens, 11:759–62.

9. Coca Payeras A. 1998. Control de la hipertensión arterial en España. Resultados del estudio Controlpres 1998. Hipertensión, 15:298–307.

10. Colhoun B, Pohhi L, Lang T, et al. 1998. Blood pressure screening, management and control in England: results from the health survey for England 1994 // J Hypertens, 16:747–52.

11. Cushman WC, Khatri I, Materson BJ, et al. 1991.Treatment of hypertension in elderly. Response of isolated systolic hypertension to various doses of hydrochlorothiazide: results of a Department of Veterans Affairs Cooperative Study Group on Antihypertensive Agents // Arch Intern Med, 151:1954–60.

12. de Leeuw F-E, de Groot JC, Oudkerk M, et al. 2002. Hypertension and cerebral white matter lesions in a prospective cohort study // Brain, 125:765–72.

13. den Heijer T, Skoog I, Oudkerk M, et al. 2003. Association between blood pressure levels over time and brain atrophy in the elderly // Neurobiol Aging, 24:307–13.

14. Dufouil C, de Kersaint-Gilly A, Besancon V, et al. 2001. Longitudinal study of blood pressure and white matter hyperintensities: the EVA MRI Cohort // Neurology, 56:921–6.

15. Elias MF, Wolf PA, D’Agostino RB, et al. 1993. Untreated blood pressure level is inversely related to cognitive functioning: the Framingham Study // J Clin Epidemiol, 138:353–64.

16. Farmer ME, Kittner SJ, Abbott RD, et al. 1990. Longitudinally measured blood pressure, antihypertensive medication use, and cognitive performance: the Framingham Study // J Clin Epidemiol, 43:475–80.

17. Fogari R, Mugellini A, Zoppi A, et al. 2003. Influence of losartan and atenolol on memory function in very elderly hypertensive patients // J Hum Hypertens, 17:781–5.

18. Fogari R, Mugellini A, Zoppi A, et al. 2004. Effects of valsartan compared with enalapril on blood pressure and cognitive function in elderly patients with essential hypertension // Eur J Clin Pharmacol, 59:863–8.

19. Folstein MF, Folstein SE, McHugh PR. 1975. «Mini-mental-state»: A practical method for grading the cognitive state of patients for the clinician // J Psychiatr Res, 12:189–98.

20. Forette F, Seux M-L, Staessen JA, et al. 1998. On behalf of the Syst-Eur Investigators. Prevention of dementia in randomized double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial // Lancet, 352:1347–51.

21. Forette F, Seux M-L, Staessen JA, et al. 2002. The prevention of dementia with antihypertensive treatment. New evidence from the Systolic Hypertension in Europe (Syst-Eur) study // Arch Intern Med, 162:2046–52.

22. Frimodt-Moeller J, Poulsen DL, Kornerup HJ, et al. 1991. Quality of life, side effects and efficacy of lisinopril compared with metoprolol in patients with mild to moderate essential hypertension // J Hum Hypertens, 5:215–21.

23. Glynn RJ, Beckett LA, Bebert LE, et al. 1999. Current and remote blood pressure and cognitive function // JAMA, 281:1438–45.

24. Goldstein G, Materson BJ, Cushman WC, et al. 1990. Treatment of hypertension in the elderly: II. Cognitive and behavioral function // Hypertension, 15:361–9.

25. Guo Z, Vootanen M, Winblad B, et al. 1999. Low blood pressure and incidence of dementia in a very old sample: dependent on initial cognition // J Am Geriatr Soc, 47:723–6.

26. In’t Veld BA, Ruitenberg A, Hofman A, et al. 2001. Antihypertensive drugs and incidence of dementia: the Rotterdam Study // Neurobiol Aging, 22:407–12. 27. Joffres MR, Ghadirian P, Fodor JG, et al. 1997. Awareness, treatment, and control of hypertension in Canada. Am J Hypertens, 10:1097–102.

27. Kilander L, Nyman H, Boberg M, et al. 1998. Hypertension is related to cognitive impairment. A 20-year follow-up of 999 men // Hypertension, 31:780–6.

28. Kukull WA, Larson EB, Teri L, et al. 1994. The Mini-Mental State Examination score and the clinical diagnosis of dementia // J Clin Epidemiol, 47:1061–7.

29. Launer LJ, Masaki K, Petrovitch H, et al. 1995. The association between midlife blood pressure levels and late-life cognitive function. The Honolulu-Asia Aging Study // JAMA, 274:1846–51.

30. Lasser NL, Nash J, Lasser VI, et al. 1989. Effects of antihypertensive therapy on blood pressure control, cognition and reactivity. A placebo-controlled comparison of prazosin, propranolol and hydrochlorothiazide. Am J Med, 23:98–103.

31. Leonetti G, Salvetti A. 1994. Effects of cilazapril and nitrendipine on blood pressure mood, and cognitive function in elderly hypertensive patients: an Italian multicenter study. J Cardiovasc Pharmacol, 24: S73–7.

32. Liao D, Cooper L, Cai J, et al. 1996. Presence and severity of cerebral white matter lesions and hypertension, its treatment, and its control. The ARIC Study. Atherosclerosis Risk in Communities Study // Stroke, 27:2262–70.

33. Lithell H, Hansson L, Skoog I, et al for the SCOPE Study Group. 2003. The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial // J Hypertens, 21:875–86.

34. Lobo A, Saz P, Marcos G, et al. 1999. Revalidation and standardization of the cognition mini-exam (first Spanish version of the Mini-Mental Status Examination) in the general geriatric population // Med Clin (Barc), 112:767–74.

35. Madden DJ, Blumenthal JA, Ekelund LG, et al. 1986. Memory performance by mild hypertensive following beta-adrenergic blockade // Psychopharmacology, 89:20–4.

36. Madden DJ, Blumenthal JA, Ekelund LG. 1988. Effects of betablockade and exercise on cardiovascular and cognitive functioning // Hypertension, 11:470–6.

37. Maxwell CJ, Hogan DB, Elby EM. 1996. Calcium-channel blockers and cognitive function in elderly people: results from the Canadian Study of Health and Aging // CMAJ, 61:501–96.

38. National High Blood Pressure Education Program. 1997. The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. // Arch Intern Med, 157:2413–46.

39. Nikolaus T, Sommer N, Becker C. 2000. Treatment of arterial hypertension with diuretic, beta- and calcium channel blockers in old patients // Z Gerontol Geriatr, 33:427–32.

40. Ogihara T, Kuramoto K. 2000. Effect of long-term treatment with antihypertensive drugs on quality of life of elderly patients with hypertension: a double-blind comparative study between a calcium antagonist and a diuretic // Hypertens Res, 23:33–7.

41. Ogihara T, Nakagawa M, Ischikawa H, et al. 1992. Effect of manidipine on cognitive function and mood in elderly hypertensive patients // Blood Press, 3(Suppl 1):135–9.

42. Palac DM, Cornish R, McDonald W, et al. 1990. Cognitive function in hypertensives treated with atenolol or propranolol // J Gen Intern Med, 5:310–18.

43. Palmer A, Fletcher A, Hamilton G, et al. 1990. A comparison of verapamil and nifedipine on quality of life // Br J Clin Pharmacol, 30:365–70.

44. Paran E, Anson O, Reuveni H. 2003. Blood pressure and cognitive functioning among independent elderly // Am J Hypertens, 16:818–26.

45. Reltan RM. 1959. Validity of the trail making test as an indication of organic brain damage // Perceptual Motor Skills, 8:271–6.

46. Schmidt GR, Schuna AA, Goodfriend TL. 1989. Transdermal clonidine compared with hydrochlorothiazide as monotherapy in elderly hypertensive males // J Clin Pharmacol, 29:98–103.

47. Scarzella L, Bergamasco B. 1989. Nicardipine in the therapy of arterial hypertension in elderly patients with the psycho-organic syndrome. Report on the results of the clinical study. Clin Ther, 130:171–8.

48. Skinner MH, Futterman A, Morrissette D, et al. 1992. Atenolol compared with nifedipine: effect on cognitive function and mood in elderly hypertensive patients // Ann Intern Med, 116:615–23.

49. Skoog I, Lernfelt B, Landahl S, et al. 1996. 15-year longitudinal study of blood pressure and dementia. Lancet, 347:1141–5.

50. Solomon S, Hotchkiss E, Saravay SM, et al. 1983. Impairment of memory function by antihypertensive medication // Arch Gen Psychiatry, 40:1109–12.

51. Soma MR, Natali M, Donetti E, et al. 1998. Effect of lercanidipine and its (R)-enantiomer on atherosclerotic lesions induced in hypercholesterolemic rabbits // Br J Pharmacol, 125:1471–6.

52. Staessen JA, Fagard R, Thijs L, et al. 1998. Subgroup and perprotocol analysis of the randomized European Trial on Isolated Systolic Hypertension in the Elderly // Arch Intern Med, 158:1681–91.

53. Steiner SS, Friedhoff AJ, Wilson BL, et al. 1990. Antihypertensive therapy and quality of life: a comparison of atenolol, captopril, enalapril and propranolol // J Hum Hypertens, 4:217–25.

54. Steufert S, Depadova A, McGlynn T, et al. 1988. Impact of beta-blockade on complex cognitive functioning // Am Heart J, 116:311–15.

55. Tedesco MA, Ratti G, Mannella S, et al. 1999. Comparison of losartan and hydrochlorothiazide on cognitive function and quality of life in hypertensive patients // Am J Hypertens, 12:1130–4.

56. Vitanen M, Guo Z, Zhu L, et al. 1998. Influence of diuretics on the occurrence and progression of dementia in a community population aged 75 years or older // Neurobiol Aging, 19: S246.


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For citations:


Tisaire-Sánchez J., Roma J., Camacho-Azcargorta I., Bueno-Gómez J., Mora-Maciá J., Navarro A. ASSESSMENT OF COGNITIVE FUNCTION IN PATIENTS WITH ESSENTIAL HYPERTENSION TREATED WITH LERCANIDIPINE. Russian Journal of Cardiology. 2011;(2):78-85. (In Russ.)

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