Impact of ARBs plus beta-blockers and other antihypertensives on cognitive impairment: a longitudinal study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Hypertension is a major modifiable risk factor for dementia, yet the specific neuroprotective benefits of different antihypertensive drug classes remain unclear. This longitudinal population-based cohort study evaluated the association between various antihypertensive agents, used as monotherapy or combination therapy, and the risk of cognitive impairment. Methods The present work is a retrospective cohort study based on electronic health records (EHR) provided by the Consellería de Sanitat Universal i Salut Pública (Valencian Regional Health Authority, Spain) from two different hospitals in Valencia: Arnau de Villanova and Hospital La Fe. The study included 28057 individuals aged ≥ 65 years receiving antihypertensive therapy. Cox proportional hazards models, adjusted for demographic and clinical covariates, and Kaplan–Meier survival analyses were performed to estimate time-to-event outcomes and hazard ratios for cognitive impairment. Results Loop diuretics and the combination of ARBs with beta-blockers, were associated with a reduced risk of cognitive impairment. Conversely, selective beta-blockers and angiotensin-converting enzyme (ACE) inhibitors were associated with an increased probability of impairment. Conclusion Antihypertensive classes display divergent neuroprotective profiles. Loop diuretics, ARBs, and ARB–beta-blocker combinations appear protective, whereas ACE inhibitors and beta-blocker monotherapy show less favorable cognitive outcomes, highlighting the need for tailored pharmacological selection in aging populations.
Source: Frontiers in Pharmacology
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223159131