Observational Study on Cognitive function And systolic blood pressure Reduction (OSCAR): preliminary analysis of 6-month data from > 10,000 patients and review of the literature

Abstract

Given the ageing population, dementia is an ever-increasing health burden. A positive correlation between cognitive decline or dementia and blood pressure levels has been indicated. There is, however, conflicting evidence over the definitive link between the use of antihypertensives and the subsequent reduction of cognitive decline. The specific use of angiotensin II receptor blockers (ARBs) in preventing vascular dementia has been investigated with eprosartan treatment. In animal studies utilising stroke-prone rats, eprosartan has been shown to reduce end-organ damage of the heart and kidneys in a study assessing cardiomyopathy and renal failure. The Morbidity and mortality after Stroke, Eprosartan compared with nitrendipine for Secondary prevention (MOSES) study, assessing 1405 patients, has shown the cerebroprotective effects of eprosartan compared with the calcium channel blocker nitrendipine. In this study, however, no change in cognitive function, as assessed by the mini-mental status examination (MMSE) score, was seen between the treatment groups. The Observational Study on Cognitive function And systolic blood pressure Reduction (OSCAR) trial, including more than 60,000 hypertensive patients, also assessed the ability of eprosartan to alter the MMSE score. In contrast to the MOSES trial, preliminary data from 10,000 patients after 6 months of treatment identified a decrease in blood pressure alongside a significant increase in MMSE score. Specific subpopulations within this study, including the elderly, patients with higher initial systolic blood pressure and patients with a body mass index (BMI) of 25-30 kg/m2 showed the greatest change in MMSE score. These data indicate an association with blood pressure reduction and improvement of cognitive function with eprosartan treatment.