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 The study was an offshoot of a more than 12,000-patient trial called
Hope-3 released earlier this year. Patients in the study with
hypertension and moderate risk of heart disease slashed their
long-term risk of heart attack and stroke by 40 percent by taking a
blood pressure medication as well as a cholesterol-lowering statin.
Under the theory that what is good for the heart is also good for
the brain, researchers conducted a series of tests in Hope-3
patients aged 70 and older, who are considered at highest risk for
cognitive decline. In all, 1,626 completed the study after being
followed for 5.6 years on average.
Subjects received a blood pressure medicine, AstraZeneca's Crestor
cholesterol fighter, or both, and all three groups were compared
with a placebo.
To the dismay of researchers, cognitive declines in all three drug
groups were virtually identical to those who received a placebo, and
about what would be expected from normal aging.
"We were pretty disappointed," said lead researcher Dr. Jackie
Bosch, who presented the data at the American Heart Association's
scientific meeting in New Orleans.
However, there was a silver lining.
Statins, which have been definitively shown to cut heart attack
risk, are among the most widely prescribed medicines in the world.
But some statin users have reported experiencing episodes of memory
loss while taking the medication.
That was not seen in this study.
"The part about statins not having a negative effect on cognition is
big," said Bosch, who is from McMaster University in Hamilton,
Ontario.
Patients undertook a series of tests at the start of the study and
upon completion to assess cognitive and functional declines.
The main one, to assess changes in psycho motor processing speed,
was a test in which patients were asked to substitute a digit that
corresponds to a symbol in a certain order over two minutes.
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Others tested executive function, such as doing banking or
high-level planning, and the ability to conduct daily activities.
There was also a questionnaire for self-reporting functional or
cognitive declines. On all measures, the declines were similar for
the drug groups and placebo.
However, researchers saw a trend toward possible benefits from drug
therapy in patients who had the highest blood pressure and LDL, or
"bad," cholesterol at the start, and in those who stayed on the
medicines for at least six years.
The benefits of starting early and continuing longer-term treatment
remains unclear, they said.
"It ain't without hope," joked Bosh, playing on the name of the
study.
"Perhaps there is a group that could benefit," she said. "We
probably have to start earlier and do it for longer."
(Reporting by Bill Berkrot)
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