Cognitive Protection by Angiotensin Converting Enzyme Inhibitors in Heart Failure

Abstract

Card io-selective medications such as angiotensin converting enzyme (ACE) inhibitor centrally active or non-centrally-active and angiotensin receptor blocker (ARB) have been researched in animals and humans for potential cognitive benefits. This secondary analysis presents results of a published cross sectional study of 90 co mmunity-dwelling adults with heart failure (HF) who were screened for cognitive impairment using the Montreal Cognitive Assessment (MoCA). The mean MoCA score was 24.73 (SD 2.76). T-test on the MoCA score and ACE inhibitor (78% of part icipants) and centrally-active ACE inhib itor (60%) were statistically significant (p= 0.01) with no association to ARBs. Bivariate analysis indicated higher dosages of ACE inhib itors were associated with better cognitive function (R= 0.211, p =0.046) with no association to ARBs. In the mult iple regression model, covariates age, education, knowledge on HF medication, and mean arterial blood pressure accounted for 33.6% of variance and ACE inhib itor added 4.1 % of variance and remained statistically significant (p=0.021); age and mean arterial blood pressure were not significant in the final regression model. Findings fro m this study provided rationale to support the protective role of A CE inhib itors on cognitive decline among HF patients.