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Lowering BP, Lipids in Healthy Elderly Has No Cognitive Effect

WEDNESDAY, Feb. 27, 2019 -- Candesartan plus hydrochlorothiazide, rosuvastatin, or their combination do not impact cognitive decline among older people, according to a study published online Feb. 27 in Neurology.

Jackie Bosch, Ph.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues randomly assigned participants without known cardiovascular disease or need for treatment to candesartan plus hydrochlorothiazide or placebo and to rosuvastatin or placebo. A total of 2,361 participants (mean age, 74 years) from 228 centers in 21 countries completed the Digit Symbol Substitution Test (DSST), the modified Montreal Cognitive Assessment, and the Trail Making Test Part B.

The researchers found that candesartan/hydrochlorothiazide reduced systolic blood pressure by 6.00 mm Hg and rosuvastatin reduced low-density lipoprotein cholesterol by 24.8 mg/dL compared with placebo. A total of 1,626 participants completed baseline and study-end assessments; follow-up was for 5.7 years. The mean difference in DSST scores was − 0.91 (95 percent confidence interval, −2.25 to 0.42), − 0.54 (95 percent confidence interval, −1.88 to 0.80), and −1.43 (95 percent confidence interval, −3.37 to 0.50) for candesartan/hydrochlorothiazide versus placebo, rosuvastatin versus placebo, and combination therapy versus double placebo, respectively. For other measures, the differences were not found to be significant.

"Blood pressure lowering with candesartan/hydrochlorothiazide, lipid lowering with rosuvastatin, and the combination did not reduce or increase the rate of cognitive or functional decline over median follow-up of 5.7 years," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including AstraZeneca, which funded the study.

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Posted: February 2019

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