Antihypertensive therapy and cerebral hemodynamics in Executive Mild Cognitive Impairment: results of a Pilot randomized clinical trial

Candesartan produced the greatest improvement in executive function, with TMT Part B improving by 17.1 seconds versus 4.2 seconds for HCTZ and worsening by 14.4 seconds for lisinopril, with significan

Effect: improvement; TMT-B improved by 17.1 seconds

There was a trend for increased resting cerebral blood flow velocity in the candesartan group compared to declines in the lisinopril and HCTZ groups, but this did not reach statistical significance in

Effect: null; Candesartan: +1.03 cm/sec; Lisinopril: -2.12 cm/sec; HCTZ: -2.40 cm/sec

Candesartan preserved cerebrovascular reserve over 12 months (no significant within-group decline in vasoreactivity or VMR), whereas lisinopril and HCTZ groups showed significant declines. However, be

Effect: null; Between-group p=0.30 for vasoreactivity; p=0.46 for VMR

All three antihypertensive regimens achieved equivalent systolic blood pressure reductions and blood pressure control rates, establishing that cognitive and hemodynamic differences between groups are

Effect: null; Lisinopril: -27±5 mmHg; Candesartan: -26±5 mmHg; HCTZ: -25±6 mmHg; p=0.93

Despite significant decreases in sitting blood pressure (21-28 mmHg systolic reduction), antihypertensive therapy was not associated with increased orthostatic blood pressure declines or worsening of

Effect: null; No increases in orthostatic BP declines in any group; no worsening of orthostatic BFV declines