Eprosartan-based hypertension therapy, systolic arterial blood pressure and cognitive function: analysis of Middle East data from the OSCAR study

Abstract

Background:Studies have indicated a relationship between hypertension and cognitive function. The possible effect of antihypertensive therapy on cognitive disorders is therefore a matter of interest.Materials and methods:The Observational Study on Cognitive function And SBP Reduction (OSCAR) was an open-label, multinational trial designed to evaluate the impact of eprosartan-based antihypertensive therapy on cognitive function in patients with essential hypertension. Eprosartan 600 mg/day for 6 months (with provision for additional medication as needed) was initiated in hypertensive subjects aged ≥50 years. A total of 853 patients in an intention-to-treat cohort from seven countries of the Middle East was identified for subgroup analysis.Results:Arterial blood pressure was reduced significantly (P < 0.001) during the study: At the end of 6 months of eprosartan-based therapy, the mean (±SD) reduction from baseline was 32.1 ± 14.3/14.6.3 ± 8.6 mmHg (P < 0.001). Mean pulse pressure was reduced by 18.3 ± 13.1 mmHg (P < 0.0001 vs baseline). Blood pressure was normalized (systolic <140 mmHg and diastolic <90 mmHg) in 68.2% of patients. The overall mean Mini-Mental State Examination (MMSE) score after 6 months of eprosartan-based therapy was one-point higher than at baseline (P < 0.001). MMSE score on completion of 6 months’ follow-up was either unchanged or increased from baseline in 793 (93%) individuals and decreased in 60 (7%). Factors associated with stability of or improvement in cognitive function included MMSE score at baseline, diastolic blood pressure (DBP) at baseline, and treatment-induced change in DBP.Conclusion:Results from the Middle East subgroup of OSCAR are supportive of the hypothesis that antihypertensive therapy based on angiotensin-receptor blocker therapy with eprosartan may be associated with preservation or improvement of cognitive function.

Roles of vascular and metabolic components in cognitive dysfunction of Alzheimer disease: short- and long-term modification by non-genetic risk factors

“…The OSCAR study (Observational Study on Cognitive function And systolic blood pressure Reduction) was conducted to confirm whether hypertensive patients treated with eprosartan show improvement in MMSE score (Shlyakhto, 2007). Results from a subgroup of OSCAR are supportive of the hypothesis that this treatment may be associated with preservation of cognitive function (Radaideh et al, 2011). Another report from OSCAR of a retrospective investigation suggested that blood pressure responses after treatment coincided with stabilization of MMSE in difficult-to-treat hypertensive patients (Petrella et al, 2012).…”

Antihypertensive therapy is associated with improved visuospatial, executive, attention, abstraction, memory, and recall scores on the montreal cognitive assessment in geriatric hypertensive patients

“…Similarly, results from the SCOPE and OSCAR trials have shown significant improvement in MMSE scores. [ 20 , 21 ] However, these trials have used the MMSE to assess cognitive function. A prospective cohort study performed in Western India which used the PGI memory scale to assess memory showed that patients taking antihypertensive therapy had significantly better immediate recall, delayed recall, and recognition scores after 3 months of antihypertensive therapy.…”

Arterial stiffness, cognitive impairment and dementia: confounding factor or real risk?

“…In a population with isolated systolic hypertension, 6‐month eprosartan treatment diminished blood pressure as well as pulse pressure leading to a small but significant improvement in cognitive scores (assessed with the MMSE) with respect to baseline measures (Radaideh et al . ). The protective effect of antihypertensives in preventing cognitive decline remains a matter of debate; for a recent discussion on this topic the reader is referred to a recent review (Iulita and Girouard ).…”