Cognitive Protection by Angiotensin Converting Enzyme Inhibitors in Heart Failure

Cardio-selective medications such as angiotensin converting enzyme (ACE) inhibitor centrally active or non-centrally-active and angiotensin receptor blocker (ARB) have been researched in animals and humans for potential cognitive benefits. This secondary analysis presents results of a published cross sectional study of 90 community-dwelling adults with heart failure (HF) who were screened for cognitive impairment using the Montreal Cognitive Assessment (MoCA). The mean MoCA score was 24.73 (SD 2.76). T-test on the MoCA score and ACE inhibitor (78% of participants) and centrally-active ACE inhibitor (60%) were statistically significant (p= 0.01) with no association to ARBs. Bivariate analysis indicated higher dosages of ACE inhibitors were associated with better cognitive function (R= 0.211, p=0.046) with no association to ARBs. In the multiple regression model, covariates age, education, knowledge on HF medication, and mean arterial blood pressure accounted for 33.6% of variance and ACE inhibitor added 4.1 % of variance and remained statistically significant (p=0.021); age and mean arterial blood pressure were not significant in the final regression model. Findings from this study provided rationale to support the protective role of ACE inhibitors on cognitive decline among HF patients.