Abstract 033: Anti-hypertensive Treatment With Acei Vs Arbs: The Differential Effect On Brain Microstructural Integrity Parameters Of Raas-targeting Treatments

Abstract

Treating hypertension by drugs targeting the RAAS either blocking the Angiotensin receptor (ARBs) or inhibiting the Angiotensin Converting Enzyme (ACEi) have beneficial effects on cardiovascular health, preventing MI, stroke and global CV mortality. It is worth noting that no study investigated whether the two strategies targeting the RAAS have different effects on brain injury in hypertensive patients. To this aim, we investigated the correlation among microstructural integrity by DTI-MRI and the use of either class of drug. We recruited 51 hypertensives on ACEi or ARBs treatment and subjected them to advanced neuroimaging. DTI measures were normalized and analyzed by general linear model with age, sex, BMI, alcohol, smoke, SBP and DBP levels, heart rate as confounders to highlight alterations correlated to either treatment. The analysis shows that ARBs and ACEi exhibit an opposite and significant correlation with the microstructural integrity of the anterior commissure and the temporal subsection of the cingulum, reflecting a preserved microstructure in patients treated with ARBs compared with ACEi. This difference is also shown in pairwise comparison on anterior commissure (Table 1). In conclusion, our data suggest that ARBs may preserve specific white matter tracts integrity, suggesting that in hypertensive patients with cognitive dysfunction the use of ARBs should be preferred to protect brain microstructural integrity.