Impact of ARBs plus beta-blockers and other antihypertensives on cognitive impairment: a longitudinal study
5 affiliations
- 1Research Group in Alzheimer Disease. Instituto de Investigación Sanitaria La Fe
- 2Cathedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, CEU Universitites
- 3Research Group in Neuroinmunology. Instituto de Investigación Sanitaria La Fe
- 4Department of Pharmacy, Universidad Cardenal Herrera-CEU, CEU Universities
- 5Department of Mathematics, Physics and Technology, Universidad Cardenal Herrera-CEU, CEU Universities
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.
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BibTeX
@article{garciazamora2026impact,
title = {{Impact of ARBs plus beta-blockers and other antihypertensives on cognitive impairment: a longitudinal study}},
author = {Mar Garcia-Zamora and Gemma García-Lluch and Lucrecia Moreno and Juan Pardo and Consuelo Cháfer-Pericas},
journal = {Frontiers in Pharmacology},
year = {2026},
month = oct,
doi = {10.3389/fphar.2026.1954416},
url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.1954416/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Impact of ARBs plus beta-blockers and other antihypertensives on cognitive impairment: a longitudinal study
AU - Mar Garcia-Zamora
AU - Gemma García-Lluch
AU - Lucrecia Moreno
AU - Juan Pardo
AU - Consuelo Cháfer-Pericas
PY - 2026
DA - 2026/10/21
JO - Frontiers in Pharmacology
DO - 10.3389/fphar.2026.1954416
UR - https://www.frontiersin.org/articles/10.3389/fphar.2026.1954416/full
AB - 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.
SN - 1663-9812
ER -