Renin–angiotensin–aldosterone system has a pivotal role in cognitive impairment

Abstract

Because dementia is associated with both deterioration in the quality of life and poor prognosis, the prevention of cognitive impairment (CI) is a critical problem in public health promotion. Hypertension is a risk factor for the aggravation of CI, and the renin-angiotensin-aldosterone system (RAAS) is a key player in the increased incidence and development of hypertension. Therefore, the RAAS is considered to be a promoting factor for CI development. Conversely, recent studies have shown that lowering blood pressure with RAAS inhibitors decreases the incidence of CI, dementia and cardiovascular disease. Blood-brain barrier-penetrating RAAS inhibitors appear to have advantages in preventing cognitive decline because they can suppress the RAAS in the hippocampus, which has an important role in cognition. Thus, RAAS blockage is a notable strategy for preventing CI.

Phosphodiesterase-4 inhibitors ameliorates cognitive deficits in deoxycorticosterone acetate induced hypertensive rats via cAMP/CREB signaling system

“…These results were found to be in agreement with earlier studies that show significantly higher blood pressure, right kidney weight and heart weight in DOCA salt-induced hypertensive rats as compared to the sham operated rats (Hacioglu et al, 2003). Hypertension is one of the most critical risk factors for cognitive impairment and the renin angiotensin aldosterone system (RAAS) is a key player in hypertension, both in a blood pressure-dependent and-independent manner (Yagi et al, 2011;Yagi et al, 2013). The functional mechanisms of hypertension increasing the risk of cognitive impairment remain ambiguous.…”

Serum concentration of eicosapentaenoic acid is associated with cognitive function in patients with coronary artery disease

“…It has been reported that vascular inflammation is associated with cognitive function [ 16 ]. EPA is known to have the ability to attenuate tumor necrosis factor-α-induced upregulation of vascular cell adhesion molecule-1, intercellular adhesion molecule-1, and monocyte chemoattractant protein-1 [ 17 ].…”

Hypertension and cognitive dysfunction in elderly: blood pressure management for this global burden

“…Activation of angiotensin 1 receptor is associated with inflammation, blood–brain barrier damage and a decrease in blood brain flow. In this context, an inhibition of the RAAS in the hippocampus (which plays a significant part in cognition) using blood–brain barrier-penetrating RAAS inhibitors may have favorable effects in preventing cognitive decline [63]. Therapy with ARBs and ACEIs, particularly using brain-penetrating drugs such as captopril, perindopril and telmisartan appears to improve blood–brain barrier function, increase cerebral blood flow and reduce inflammation.…”