The effect of anti-hypertensive medication acting on the rennin-angiotensin
system on cognitive function
 
   Lead Investigator:    Kyle Steenland
   Institution      :    Emory
   E-Mail           :    nsteenl@emory.edu
   Proposal ID      :    351


   Publications:


1  Wharton W, Goldstein FC, Zhao L, Steenland K, Levey AI, Hajjar I
   Modulation of Renin-Angiotensin System May Slow Conversion from Mild Cognitive Impairment to Alzheimer's Disease
   Journal Article  J Am Geriatr Soc,63:1749-1756,2015,PMC4743657

   PUBLISHED





   Proposal Description:
   While research linking RAS-acting BP medications to AD continues to mount, the mechanism has yet to be clarified, and it is unknown to what extent these factors interact with genetics and ethnicity. Because it has been well documented that the RAS functions differently in African Americans and Caucasians, it is important to address these mechanistic questions in both populations. The main objective of the proposed study is to examine the extent to which BP medications are related to cognitive task performance in both non-Hispanic Caucasians and African Americans. To address this important research question ??? we are requesting NACC demographic data, medication data and neuropsychological data at all timepoints. We hypothesize that more Caucasian than African Americans will be prescribed RAS acting medications. We further hypothesize that participants taking RAS acting, BBB crossing medications will exhibit less cognitive decline and slower disease progression that participants taking non BBB crossing, RAS acting medications and other antihypertensive classes (i.e. diuretics and calcium channel blockers). Cognitive decline will be evaluated via longitudinal data on standard tests, using repeated measures analysis, and transition to MCI or AD will be evaluated via survival analysis. The population of interest will be those classified as either normal or MCI at baseline. We will categorize BP medications by RAS acting vs. non-RAS acting, and further into those RAS acting medications that cross the BBB vs. those that do not. Depending on results, we then plan for additional analyses using NACC neuropathology data, to investigate whether any relationship between cognition and BP medication is due to A?? levels.