Stopping Blood Pressure Meds May Not Help Cognition

Antihypertensive medication cessation may not reverse cognitive impairment in older adults

(RxWiki News) Any medication can cause side effects, and high blood pressure medications are no exception.

Low blood pressure has recently been linked to impaired cognitive function in elderly patients.

However, a new study from the Netherlands found that patients who discontinued taking their antihypertensive (blood pressure) medications did not experience a reversal in mild cognitive impairment.

In a related editorial, Michelle C. Odden, PhD, of the College of Public Health and Human Sciences at Oregon State University, wrote, "Their study was motivated by the evidence demonstrating an association between lower blood pressure and greater decline in cognitive function and by the hypothesis that increasing blood pressure would help maintain better perfusion of the brain."

This study was led by Justine E. F. Moonen, MD, of the Department of Psychiatry at Leiden University Medical Center in the Netherlands.

Dr. Moonen and team looked at 385 patients age 75 or older with mild cognitive decline. None of these patients had serious heart disease. All were previously taking antihypertensive drugs.

These patients were split into two groups, one of which discontinued taking antihypertensive drugs.

Cognitive function, depression, apathy, functional status and quality of life were then monitored for 16 weeks.

After that time, no mental differences were found between the two groups.

Although those who discontinued antihypertensive treatment did show an increase in blood pressure, cognitive function did not improve.

"We have made great strides in building the evidence base for initiating and intensifying antihypertensive therapy, but we have neglected to study the effects of continuing and discontinuing therapy in older adults," Dr. Odden wrote. "This study is the first step forward in answering these important scientific questions."

The study and editorial were published Aug. 24 in the journal JAMA Internal Medicine.

Priority Medicines for the Elderly and the Netherlands Organization for Health Research and Development funded this research. No conflicts of interest were disclosed.

Review Date: 
August 24, 2015