ACE inhibitors that can cross the blood-brain barrier may help prevent dementia, according to findings presented at the American Geriatrics Society meeting in Seattle in May.

Using data from a larger, multicity cardiovascular trial, investigators at the Wake Forest University School of Medicine in Winston-Salem, N.C., examined the records of 1,142 elderly patients (mean age 75 years) with hypertension who were free of dementia at baseline.

At six years’ follow-up, investigators found that for each year people took centrally-acting ACE inhibitors, they had a 50% lower rate of mental decline than people taking other kinds of antihypertensive drugs, irrespective of other health behaviors. Mental decline was measured using the Modified Mini-Mental State Exam.

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Investigators speculate that the ACE inhibitors work by reducing inflammation that might contribute to dementia. Examples of centrally-acting agents include captropil (Capoten), fosinopril (Monopril), lisinopril (Prinivil and Zestril), and trandolapril (Mavik).