Abstract-The Dahl salt-sensitive (DS) rat, a genetic model of salt-induced hypertension in humans, is more likely to develop severe vascular injuries than a rat with spontaneous hypertension. We designed an experiment to scrutinize the effects of renin-angiotensin inhibition on cognitive dysfunction in the aged, normotensive DS with a passive avoidance test. Eighteen months of treatment with a very low dose of the angiotensin-converting enzyme (ACE) inhibitor cilazapril (2.5 g/mL in drinking water) or the angiotensin II type 1 receptor antagonist E4177 did not reduce blood pressure throughout the experiment, although in the low dose cilazapril group (12.5 g/mL in drinking water), blood pressure dropped within 6 months after treatment began. The cilazapril treatments dose-dependently improved memory function in the aged, normotensive DS fed a low-salt diet compared with the untreated, control rats. This improvement was associated with significant increases in hippocampal CA1 cells and capillary densities in the CA1 regions compared with those in the untreated DS. Similarly, E4177 slightly improved the memory dysfunction observed in the aged DS. The cells in the hippocampal CA1 region were restored slightly, but the capillary densities were not influenced by the receptor antagonist. On the other hand, the ACE inhibitor and receptor antagonist both attenuated urinary protein excretions with an improvement of glomerular sclerosis. These data suggest that long-term treatment with an ACE inhibitor improves memory dysfunction probably through restoration of capillary and hippocampal cells. The effects are due to the inhibition of the angiotensin II type 1 receptor and probably to the enhancement of the kallikrein-kinin system. (Hypertension. 1999;34:496-502.)Key Words: cilazapril Ⅲ angiotensin-converting enzyme inhibitors Ⅲ receptors, angiotensin Ⅲ memory Ⅲ cognition Ⅲ rats, aging Ⅲ aging R ecent advances in vascular physiology have emphasized an integration of multiple risk factors that form vascular lesions in patients with various disorders that affect the cardiovascular system. The understanding of the process of vascular lesion development has led to the establishment of pharmacological and nonpharmacological strategies for the prevention of vascular damage in hypertension, hyperlipidemia, or abnormal glucose metabolism. In addition to such acquired forms of risk factors, some inevitable factors, eg, gender, genetic loading, and aging, contribute to the progression of vascular injuries. Among these factors, aging is particularly important. The development of a therapeutic strategy for the aging population is urgently needed. In Japan, by year 2015, people Ն65 years of age will constitute 25% of the population, and worldwide, by year 2025, this population will have doubled. In addition, Ϸ50% of dementia or cognitive dysfunction in the elderly are attributable to cerebrovascular lesions. 1 The elucidation of the mechanism of cerebrovascular lesions related to the process of aging provides a useful strategy to preven...