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