BETTER MEMORY AND EXECUTIVE FUNCTIONS IN MIDDLE-AGED TREATMENT NAIVE HYPERTENSIVE PATIENTS RECEIVING FIXED-DOSE COMBINATION TREATMENT WITH PERINDOPRIL ARGININE/INDAPAMIDE

Abstract

Objective: To investigate the effect of perindopril arginine/indapamide fixed-dose combination (FC) on 24-hour blood pressure (BP) and cognitive functions in treatment-naive middle-aged patients with uncomplicated grade 1–2 essential arterial hypertension (EAH). Design and method: The open prospective study enrolled 35 patients (12 men, 22 women) aged 40–59 years with a diastolic BP of 90–109 mmHg and/or a systolic BP of 140–179 mmHg by office measurements. Patients received perindopril arginine 5 mg /indapamide 1.25 FC (Pa/I FC) once daily in the morning; if necessary, after 2 weeks (if office BP was >/ = 140/90 mmHg) the dosage was increased up to perindopril 10 mg/ indapamide 2.5. The follow-up period was 14–16 weeks. At the baseline and at the end of the follow-up, all patients underwent 24-hour ambulatory BP monitoring (ABPM) and neuropsychological assessment (Montreal Cognitive Assessment (MoCA), 10-words list learning task (immediate and delayed recall), verbal fluency test (literal and categorical fluency), Trail making test (TMT), part A and part B), and Stroop test). Results: At the end of the follow-up period, treatment with Pa/I FC showed a significant reduction in BP levels (office measurements and ABPM (during 24-hour, awake and sleep periods); a significant improvement in cognitive performance: an increase in the number of words in the 10-words list learning task during both immediate (5.3 ± 1.7 vs. 5.8 ± 1.1words; p < 0.05) and delayed (6.2 ± 1.7 vs. 7.3 ± 1.5 words; p < 0.05) recalls, a decrease in the performance time of TMT B (116.9 ± 44.0 vs. 91.8 ± 27.6 sec; p < 0.01), TMT B – TMT A difference score (79.4 ± 42.97 vs. 54.2 ± 26.7; p < 0.01) and Stroop test Part 3 (133.6 ± 48.3 to 110.8 ± 19.4 sec; p < 0.01), a larger number of words in the categorical fluency test (6.7 ± 2.4 vs 8.2 ± 2.7; p < 0.05). Conclusions: The results obtained indicate that in treatment-naive middle-aged patients with EAH, Pa/I FC assures an effective reduction in office and ABPM levels of BP, and improves cognitive functions, particularly attention, information processing speed, semantic memory, cognitive flexibility, and short-term and long-term memory.