Angiotensin Receptor Blockers and Cognition: a Scoping Review.

IF 3.9 2区医学 Q1 PERIPHERAL VASCULAR DISEASE

Current Hypertension Reports Pub Date : 2024-01-01 Epub Date: 2023-09-21 DOI:10.1007/s11906-023-01266-0

Zhen Zhou, Suzanne G Orchard, Mark R Nelson, Michelle A Fravel, Michael E Ernst

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引用次数: 0

Abstract

Purpose of review: To provide an overview of the association between angiotensin II receptor blocker (ARB) use and cognitive outcomes.

Recent findings: ARBs have previously shown greater neuroprotection compared to other anti-hypertensive classes. The benefits are primarily attributed to the ARB's effect on modulating the renin-angiotensin system via inhibiting the Ang II/AT1R pathway and activating the Ang II/AT2R, Ang IV/AT4R, and Ang-(1-7)/MasR pathways. These interactions are associated with pleiotropic neurocognitive benefits, including reduced β-amyloid accumulation and abnormal hyperphosphorylation of tau, ameliorated brain hypo-fusion, reduced neuroinflammation and synaptic dysfunction, better neurotoxin clearing, and blood-brain barrier function restoration. While ACEis also inhibit AT1R, they simultaneously lower Ang II and block the Ang II/AT2R and Ang IV/AT4R pathways that counterbalance the potential benefits. ARBs may be considered an adjunctive approach for neuroprotection. This preliminary evidence, coupled with their underlying mechanistic pathways, emphasizes the need for future long-term randomized trials to yield more definitive results.

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血管紧张素受体阻滞剂与认知：范围界定综述。

综述目的：概述血管紧张素II受体阻滞剂（ARB）的使用与认知结果之间的关系。最近的发现：与其他抗高血压药物相比，ARBs先前显示出更大的神经保护作用。其益处主要归因于ARB通过抑制Ang II/AT1R途径和激活Ang II/AT 2R、Ang IV/AT4R和Ang-（1-7）/MasR途径调节肾素-血管紧张素系统的作用。这些相互作用与多效性神经认知益处有关，包括减少β-淀粉样蛋白积累和tau异常过度磷酸化，改善大脑低融合，减少神经炎症和突触功能障碍，更好地清除神经毒素，恢复血脑屏障功能。虽然ACE也抑制AT1R，但它们同时降低Ang II并阻断Ang II/AT2R和Ang IV/AT4R通路，从而抵消潜在的益处。ARBs可能被认为是一种神经保护的辅助方法。这一初步证据，加上其潜在的机制途径，强调了未来长期随机试验的必要性，以产生更明确的结果。

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来源期刊

Current Hypertension Reports 医学-外周血管病

CiteScore

10.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of hypertension. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antihypertensive therapies, associated metabolic disorders, and therapeutic trials. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.