Impact of Angiotensin Receptor Blockers on Alzheimer Disease Neuropathology in a Large Brain Autopsy Series

Abstract

Observational studies suggest that angiotensin receptor blockers (ARBs) may have superior effects on cognitive function compared with other antihypertensive medications. In a recent large cohort of American veterans, Li et al1 reported that treatment with ARBs was associated with lower risks for dementia and Alzheimer disease (AD) compared with other antihypertensive agents, including angiotensin-converting enzyme inhibitors (ACEIs). The association between concurrent elevation in blood pressure and AD is not consistent.2-4 This may be in part related to the inconsistent processes by which AD was adjudicated and confirmed. A pathologic examination is the most accurate process to confirm AD but is not feasible in many observational studies and clinical trials.