Protective role of brain-penetrating ACE inhibitors against cognitive decline in elderly patients with hypertension

Takashi Ohrui, Katsutoshi Furukawa, Hiroyuki Arai

Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University

　　There is increasing evidence that certain components of the renin angiotensin system (RAS) may have a crucial role in learning and memory processes. Angiotensin-converting enzyme (ACE) is over-expressed in the hippocampus, frontal cortex, and caudate nucleus of patients with Alzheimer disease (AD).　We have shown that brain-penetrating ACE inhibitors can reduce the incidence of AD in elderly hypertensive patients and that the brain-penetrating ACE inhibitors significantly reduce the rate of cognitive decline in mild to moderate AD patients. These results suggest that brain-penetrating ACE inhibitors might directly modify the brain renin-angiotensin system and might provide a novel strategy for the treatment of AD.

Address correspondence to Dr. Takashi Ohrui, Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University(4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan)