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Stress-induced blood pressure elevation in subjects with mild cognitive impairment: effects of the dual-type calcium channel blocker, cilnidipine.

AbstractAIM:
We investigated whether mental stress-induced blood pressure elevation was related to cognitive function in the elderly, and further examined the effects of the dual-type calcium channel blocker, cilnidipine, on stress induced hypertension in subjects with mild cognitive impairment.
METHODS:
In study I, 39 consecutive outpatients (mean age +/- standard deviation, 77 +/- 8 years), who were referred to our memory clinic and were not taking any medications, were studied. They were divided into three groups according to cognitive function on the Hasegawa Dementia Scale-Revised (HDSR): group 1 (n = 8), 28 points or more; group 2 (n = 18), 21-27 points; and group 3 (n = 13), 20 points or less. In study II, 14 outpatients with hypertension and mild cognitive impairment (aged 79 +/- 8 years; HDSR score, 24 +/- 4) were assigned to receive cilnidipine (10-20 mg/day). The control group (n = 10) matched for age, HDSR and blood pressure was followed without cilnidipine.
RESULTS:
In study I, although age and basal blood pressure were similar among the three groups, the blood pressure response to a mental arithmetic test was twice as large in group 2 (26 +/- 12 mmHg in systolic pressure and 11 +/- 8 mmHg in diastolic pressure) as those in groups 1 and 3. In study II, after 4 weeks, cilnidipine treatment significantly decreased the blood pressure responses to the mental arithmetic test compared to the baseline as well as to those of the control group.
CONCLUSIONS:
Stress-induced blood pressure elevations are exaggerated in subjects with mild cognitive impairment. Cilnidipine may have inhibitory effects on stress-induced hypertension.
AuthorsYumiko Kawashima, Masahiro Akishita, Hiroshi Hasegawa, Koichi Kozaki, Kenji Toba
JournalGeriatrics & gerontology international (Geriatr Gerontol Int) Vol. 8 Issue 4 Pg. 278-83 (Dec 2008) ISSN: 1447-0594 [Electronic] Japan
PMID19149840 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Calcium Channel Blockers
  • Dihydropyridines
  • cilnidipine
Topics
  • Aged
  • Aged, 80 and over
  • Calcium Channel Blockers (therapeutic use)
  • Case-Control Studies
  • Cognition Disorders (complications)
  • Dihydropyridines (therapeutic use)
  • Humans
  • Hypertension (drug therapy, etiology, psychology)
  • Stress, Psychological

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