Wall Street Journal
February 12, 2008, 8:51 am
Posted by Jacob Goldstein
Here’s what the vice chairman of medicine at New York Presbyterian Hospital says about the effects of Lipitor on the cognitive function of some women: “This drug makes women stupid.”
Pfizer, which sells the cholesterol drug, says the pill has been tested in 400 clinical trials and racked up 145 million patient years of experience. The extensive data “do not establish a casual link between Lipitor and memory loss,” Pfizer says
And, as the WSJ’s Melinda Beck notes in today’s Health Journal column, the patient information sheet for the drug does not list cognitive issues such as memory loss or fuzzy thinking among the drug’s possible side effects. But the article also notes that anecdotal reports of a connection between statins and mental problems in some patients have been “rampant for years.”
The problem with anecdotal evidence, of course, is that it could always be coincidence masquerading as causality — the patients might have had memory problems even if they weren’t on the drug. And most cardiologists say the benefits of statins far outweigh any risks.
In any case, a clearer picture may be forthcoming: Researchers at the University of California at San Diego will soon complete a randomized controlled trial examining the effects of statins on thinking, mood, behavior and quality of life.
Showing posts with label Cognition. Show all posts
Showing posts with label Cognition. Show all posts
Wednesday, February 13, 2008
Saturday, September 29, 2007
Antihypertensive Treatment May Help Maintain Memory
Antihypertensive Treatment May Help Maintain Memory
Caroline Cassels
Medscape Medical News 2007. © 2007 Medscape
September 27, 2007 — New research indicates antihypertensive treatment leads to increased, joint activation of brain areas responsible for memory performance — a finding that suggests such treatment may help patients maintain cognition and memory.
A study led by J. Richard Jennings, PhD, from the University of Pittsburgh, in Pennsylvania, and presented at the American Heart Association (AHA) 61st Annual Fall Conference of the Council for High Blood Pressure Research, showed patients had a 2-fold increase in the joint activation of these areas of the brain after a year of treatment with either the angiotensin-converting enzyme lisinopril or beta blocker atenolol.
While there is an established link between hypertension and mild cognitive deficits, the mechanism has not been clear. Previous research by Dr. Jennings's team used brain imaging to examine the correlation among the activation of the prefrontal areas, parietal areas, and amygdala/hippocampus in hypertensives compared with controls and found it was higher in individuals with high blood pressure.
Increased Correlation
"In the first study, we found that in hypertensive individuals the correlation between levels of activation of these areas of the brain was 0.61. Our next question was, If we successfully treated these individuals [for hypertension], would this finding be reversed and would their brain function look more like normotensives?" Dr. Jennings told Medscape Neurology & Neurosurgery.
"To our surprise, we found that rather than decreasing, the correlation increased to 0.90. Thus, these areas of the brain were nearly always activated at the same level, suggesting there was less specificity, which means that instead of each area doing its own specific job, they were all working at the same time to try to solve the [memory] task," he added.
The study included 28 never-medicated hypertensives, randomized to receive treatment with lisinopril or atenolol for 1 year. All patients underwent psychological and physiological tests, magnetic resonance structural imaging, and positron emission tomography.
Pretreatment correlation of parietal and prefrontal change was 0.61 vs 0.94 after treatment. According to the investigators, similar differences were observed for all areas, with an average pretreatment correlation of 0.66 vs an average posttreatment correlation of 0.91.
Mental Fatigue?
These findings, said Dr. Jennings, suggest hypertensive patients' brains adapt to maintain their intellectual function and that antihypertensive treatment appears to maintain or even augment this adjustment.
At this point, said Dr. Jennings, it is not clear whether there is a "cost" associated with the brain's adaptation to hypertension. "It could mean that [in patients with hypertension] the brain has to work harder, and this could result in mental fatigue, but at this point we just don't know," he said.
This question, he added, will be the focus of future research. In addition, he said, the investigators also want to look at different types of antihypertensive treatments to determine whether they have effects similar to the 2 agents studied in the current work.
According to AHA president Daniel Jones, MD, this study provides reassurance to individuals concerned about potential adverse cognitive effects of antihypertensive treatment. "Treating hypertension is beneficial not only for extending life, but also for improving quality of life," he said in a statement.
The study was funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health.
American Heart Association 61st Annual Fall Conference of the Council for High Blood Pressure Research: Abstract P105. Presented September 27, 2007.
Caroline Cassels
Medscape Medical News 2007. © 2007 Medscape
September 27, 2007 — New research indicates antihypertensive treatment leads to increased, joint activation of brain areas responsible for memory performance — a finding that suggests such treatment may help patients maintain cognition and memory.
A study led by J. Richard Jennings, PhD, from the University of Pittsburgh, in Pennsylvania, and presented at the American Heart Association (AHA) 61st Annual Fall Conference of the Council for High Blood Pressure Research, showed patients had a 2-fold increase in the joint activation of these areas of the brain after a year of treatment with either the angiotensin-converting enzyme lisinopril or beta blocker atenolol.
While there is an established link between hypertension and mild cognitive deficits, the mechanism has not been clear. Previous research by Dr. Jennings's team used brain imaging to examine the correlation among the activation of the prefrontal areas, parietal areas, and amygdala/hippocampus in hypertensives compared with controls and found it was higher in individuals with high blood pressure.
Increased Correlation
"In the first study, we found that in hypertensive individuals the correlation between levels of activation of these areas of the brain was 0.61. Our next question was, If we successfully treated these individuals [for hypertension], would this finding be reversed and would their brain function look more like normotensives?" Dr. Jennings told Medscape Neurology & Neurosurgery.
"To our surprise, we found that rather than decreasing, the correlation increased to 0.90. Thus, these areas of the brain were nearly always activated at the same level, suggesting there was less specificity, which means that instead of each area doing its own specific job, they were all working at the same time to try to solve the [memory] task," he added.
The study included 28 never-medicated hypertensives, randomized to receive treatment with lisinopril or atenolol for 1 year. All patients underwent psychological and physiological tests, magnetic resonance structural imaging, and positron emission tomography.
Pretreatment correlation of parietal and prefrontal change was 0.61 vs 0.94 after treatment. According to the investigators, similar differences were observed for all areas, with an average pretreatment correlation of 0.66 vs an average posttreatment correlation of 0.91.
Mental Fatigue?
These findings, said Dr. Jennings, suggest hypertensive patients' brains adapt to maintain their intellectual function and that antihypertensive treatment appears to maintain or even augment this adjustment.
At this point, said Dr. Jennings, it is not clear whether there is a "cost" associated with the brain's adaptation to hypertension. "It could mean that [in patients with hypertension] the brain has to work harder, and this could result in mental fatigue, but at this point we just don't know," he said.
This question, he added, will be the focus of future research. In addition, he said, the investigators also want to look at different types of antihypertensive treatments to determine whether they have effects similar to the 2 agents studied in the current work.
According to AHA president Daniel Jones, MD, this study provides reassurance to individuals concerned about potential adverse cognitive effects of antihypertensive treatment. "Treating hypertension is beneficial not only for extending life, but also for improving quality of life," he said in a statement.
The study was funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health.
American Heart Association 61st Annual Fall Conference of the Council for High Blood Pressure Research: Abstract P105. Presented September 27, 2007.
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