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Use of Angiotensin II Receptor Blockers, Angiotensin I-Converting Enzyme Polymorphism and Associations with Memory Performance in Older People

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Abstract

We explored the relationships between the use of Angiotensin II receptor blockers (ARBs), Angiotensin I-converting enzyme (ACE) genetic polymorphisms and memory performance in older adults, whilst controlling for confounders. Retrospective observational case-control study. 104 patients over 60 years of age (mean age 74) without known cognitive disorder were included, 52 cases (ARB users) and 52 controls (non-users). ACE insertion/deletion (ACE I/D) polymorphism was determined in all patients. The Wechsler Memory Scale (memory quotient) was used to evaluate cognition. We measured years of education, Charlson Comorbidity Index (CCI) and total number of medications taken. The mean (SD) age in cases and controls were: 75.3 (7.5) and 72.0 (7.0) respectively (p = 0.020). Cases had higher CCI (p = 0.006) and took more medications (p < 0.001). Cases had a higher memory quotient: 99.6 (5.9) and 95.3 (6.7) (p < 0.001). In the I/I group, cases had higher memory quotient [99.5 (5.5) vs. 95.0 (5.7), p = 0.005]. No significant difference in memory performance was found between cases and controls within genotype ACE I/D (p = 0.056) and D/D (p = 0.290). A multiple linear regression predicting memory score in n = 104 (predictors: ARB use, age, female sex, years of education, CCI, number of medications, ACE I/I status, interaction ARB user ACE I/I status) suggested that only ARB use (p = 0.001) and higher education (p < 0.001) were significant predictors of higher memory performance. Despite ARB users being older and more comorbid, their memory was better even when controlling for the ACE I/I risk genotype. Education may confer cognitive reserve. The protective role of ARBs merits further investigation.

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Funding

ESSALUD—Kaelin Grant, Institute of Health Technology Assessment and Research-IETSI. Lima Peru. Resolution no. 04-IETSI-ESSALUD-2016.

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Authors and Affiliations

  1. Universidad de San Martín de Porres, Facultad de Medicina Humana, Instituto de Investigación, Alameda del Corregidor 1531, 15024, La Molina, Lima, Peru

    T. J. Oscanoa, F. A. Lizaraso-Soto, M. L. Guevara & R. M. Fujita

  2. Geriatric Department, Hospital Almenara, ESSALUD, Lima, Peru

    T. J. Oscanoa, E. C. Cieza, O. Grimaldo & Y. B. Andia

  3. Universidad Nacional Mayor de San Marcos, Facultad de Medicina, Lima, Peru

    T. J. Oscanoa & E. C. Cieza

  4. Discipline of Medical Gerontology, Mercer’s Institute for Successful Ageing, St James’s Hospital, D08 NHY1, Dublin 8, Ireland

    R. Romero-Ortuno

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  1. T. J. Oscanoa
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Correspondence to T. J. Oscanoa.

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Conflict of interest. The authors declare that they have no conflict of interest.

Statement of compliance with standards of research involving humans as subjects.

—All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Bioethics Committee of the Hospital Almenara—ESSALUD, Lima, Peru.

—This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Hospital Almenara, Lima, Peru (May 2016).

—Approval was obtained from the ethics committee of Ethics Committee of the Hospital Almenara, Lima Peru (May 2016). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

—The questionnaire and methodology for this study was approved by the Human Research Ethics committee of the Almenara Hospital-ESSALUD (Ethics approval number: carta no. 129-CEI-OCIDG-G-RAA-ESSA\({{\tilde {N}}}\)UD-2016).

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Oscanoa, T.J., Cieza, E.C., Grimaldo, O. et al. Use of Angiotensin II Receptor Blockers, Angiotensin I-Converting Enzyme Polymorphism and Associations with Memory Performance in Older People. Adv Gerontol 11, 208–213 (2021). https://doi.org/10.1134/S2079057021020107

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