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ARB therapy may cut risk of Alzheimer’s

Angiotensin-receptor blocker (ARB) therapy may cut the risk of Alzheimer’s disease by reducing amyloid deposition in the brain.

“To our knowledge, this is the first human evidence to suggest that treatment with ARBs may have a selective beneficial effect on amyloid metabolism,” De. Ihab Hajjar, and colleagues from University of Southern California – Los Angeles, reported.

Earlier this year, Hajjar’s group reported results of a small study suggesting that ARB therapy may improve cognitive function in older adults with early cognitive impairment.

This is the first time that a mechanism for the ARB’s protective effect, but not the first observation that it can be potentially preventive in Alzheimer’s. Several research teams have found evidence that ARB therapy may protect against cognitive decline and dementia.

In 2010, as reported by Medscape Medical News, a study by Dr. Wolozin and colleagues found a significant reduction in the incidence of Alzheimer’s and dementia among ARB users compared with users of angiotensin-converting enzyme (ACE) inhibitors or other cardiovascular drugs. The risk for Alzheimer’s was 24 percent lower in those prescribed ACE inhibitors.

In 2011, a large British study confirmed this result, finding a 53 percent lower risk for AD in older adults prescribed an ARB compared with those prescribed other antihypertensive agents.

I tell my patients to add ARBs to coffee and coconut oil as possible agents to decrease the risk of Alzheimer’s dementia. For those with hypertension, diabetes (ARBs also protect diabetic kidneys) or congestive heart failure (ARBs are typically part of the treatment regimen) clearly an ARB should be included in therapy, even though the data is not entirely clear.

Its use, based on this data, especially in those at high risk for Alzheimer’s (like a family history of dementia) is compelling. The question is, should we prescribe the drug to others who are at high risk?

Every drug has side effects and there is also the question of cost (many ARBs are now available in generics and so cost should not be the deciding factor any more). This needs to be decided by the primary care doctor, nurse practitioner and/or neurologist.

Here is a list of ARBs:
• Candesartan – Atacand
•Eprosartan – Teveten
• Irbesartan – Avapro
• Losartan – Cozaar
• Olmesartan – Benicar (Benicar has been associated with abdominal pain, cramping and diarrhea)
• Telmisartan – Micardis
• Valsartan – Diovan