BMJ 1996;313:166 (20 July)

Letters

Effect of antihypertensive treatment on cognitive function of older patients

Effect is not proved

EDITOR,--On the basis of the results of two cognitive tests Martin J Prince and colleagues conclude that hypertensive drug regimens in elderly people impair cognition no more than does a placebo.1 This may lead to the changes suggested by the key message "Concerns about damaging cognition should not deter doctors from treating hypertension in older patients." We have concerns about the study's design: the nature of the outcome measures used, the lack of any run in period before treatment to minimise practice effects, and the use of slopes as measures of individual learning rates.

Any battery of cognitive tests for elderly people should test four fundamental cognitive factors: perceptual speed, working memory capacity, access to long term memory, and spatial orientation.2 In this study the authors analysed the variance associated with the paired associate learning task and the Reitan trail making test. Both tasks have methodological . . . [Full text of this article]


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Relevant Article

Is the cognitive function of older patients affected by antihypertensive treatment? Results from 54 months of the Medical Research Council's treatment trial of hypertension in older adults
Martin J Prince, Anne S Bird, Robert A Blizard, and Anthony H Mann
BMJ 1996 312: 801-805. [Abstract] [Full Text]

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