Does angiotensin-converting-enzyme inhibitor therapy improve cognitive function in heart failure patients?
Michael Böhm* and Ingrid Kindermann
Correspondence *Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, 66421 Homburg/Saar, Germany
Email boehm@med-in.uni-saarland.de
This article has no abstract so we have provided the first paragraph of the full text.
Chronic heart failure and cognitive impairment are common problems for elderly patients and are associated with a high morbidity and mortality. Recent interest has focused on the deficits in memory and the intellectual abilities of patients with chronic heart failure. Although there is a paucity of systematic information on the association between chronic heart failure and cognitive functioning,1 cerebrocardiac comorbidity is high, with 30–50% of elderly heart failure patients also having cognitive dysfunction.2 This comorbidity has a very strong correlation with poor outcome, in either condition.3 So-called 'cardiogenic dementia' has been suggested to be caused by cerebral hypoperfusion.2 Patients with heart failure on vasodilators with blood pressure below 130 mmHg are at particular risk.3 In addition to hemodynamic hypoperfusion, impaired cerebrovascular reactivity has been reported in patients with different classes of heart failure.4 Activation of the renin–angiotensin–aldosterone system and, in particular, increased expression of ACE in the heart is a typical feature of neuroendocrine activation in chronic heart failure. In the brain, ACE activation, endothelial dysfunction and increased production of superoxide has been observed in heart failure induced by myocardial infarction.5
Full text of this article is available with one of the following:
- Personal subscription Purchase your own personal subscription to this journal. Already a subscriber? Please log in for immediate access.
- 7 day single article pass for US$18 In order to purchase this article you must be a registered user. Please register or log in.
- Site licence Learn more about institutional site licences
Current Subscribers
Please log in to access the full text article using the login box at the top of the page.
