Ongoing trials involving angiotensin-converting enzyme inhibitors

Captopril and enalapril improve cognition and depressed mood in hypertensive patients

In this study, we evaluate the effects of two angiotensin converting enzyme inhibitors (ACEIs), captopril and enalapril given chronically as antihypertensive treatment, on certain cognitive and emotional processes in humans. Thirty-nine subjects with mild to moderate hypertension and fifteen normotensive controls were divided into four groups consisting of normotensive and hypertensive subjects taking captopril, enalapril, or no medication at all. The Rey Auditory Verbal Learning Test and the Wechsler Memory Scale were used to evaluate their cognitive functioning. Mood changes in all subjects were assessed using the Beck Depression Inventory and the Hopkins Symptom Check- list (HSC).

RESULTS

Untreated hypertensive patients scored lower than normotensive controls in cognitive tests and significantly worse in cumulative recall (P < 0.05) and paired words association (P < 0.01). When compared with normotensive subjects, untreated hypertensive patients also scored significantly higher on the depression with anxiety subscale in HSC (P < 0.05). No significant influence of hypertension was found in any other examined aspect of cognition and mood. In most cases captopril improved and enalapril reversed the adverse memory effects of hypertension. High arterial blood pressure is significantly associated with an impairment of cognition and the occurrence of depression with anxiety in humans. Enalapril and, to a lesser extent, captopril reversed these deficits.