Table 1.

Randomized controlled trials about antihypertensive treatments and dementia/cognitive decline.

Study setting	Participants and follow up	Treatment	Test	Main results
Systolic hypertension in Europe study (Syst- Eur) [5]	2.418 systolic hypertensives; mean age 70 years, followup 3.9 years	CCB (nitrendipine) with possible addition of ACE-I (enalapril), diuretic (hydrochlorothiazide), or both versus placebo	MMSE	Mean difference in BP between treatment groups and the control was 7.0 mm Hg SBP and 3.2 mm Hg DBP. Rates of dementia for patients in the active treatment groups and the control groups were 3.3 and 7.4 cases per 1.000 patient-years (relative risk reduction: 55%), respectively. Significant.
The perindopril protection against recurrent stroke study (PROGRESS) [6]	6.105 subjects with prior stroke or transient ischemic attack; mean age 64 years, followup 3.9 years	ACE-I (perindopril) with possible addition of diuretic (indapamide) versus placebo	MMSE	Mean difference in BP between treatment groups and the control was 9.0 mm Hg SBP and 4.0 mm Hg DBP. Rates of cognitive decline for patients in the active treatment groups and the control groups were 11.0 and 9.1% (relative risk reduction: 19%), respectively. Significant.
Systolic hypertension in the elderly program (SHEP) [7]	4.736 systolic hypertensives; mean age 72 years, followup 4.5 years	Diuretic (chlorthalidone) with possible addition of β blocker (atenolol) or sympathetic nervous blocker (reserpine) versus placebo	Short CARE	Mean difference in BP between treatment groups and the control was 12.0 mm Hg SBP and 4.0 mm Hg DBP. Rates of dementia incidence for patients in the active treatment groups and the control groups were 3.6 and 4.2 cases per 1.000 patient-years (relative risk reduction: 14%), respectively. Not significant.
Study on cognition and prognosis in the elderly (SCOPE) [8]	4.964 hypertensives; SBP160-170/DBP 90–99 mm Hg; aged 70– 89, followup 3.97 years	ARB (candesartan) versus placebo; open-label antihypertensive drugs were added to both groups	MMSE	Mean difference in BP between treatment groups and the control was 3.2 mm Hg SBP and 1.6 mm Hg DBP. Rates of dementia incidence for patients in the active treatment groups and the control groups were 6.3 and 6.8 cases per 1.000 patient-years, respectively. Not Significant.
Hypertension in the very elderly trial cognitive function assessment (HYVET- COG) [9]	3.336 hypertensives; SBP 160–200 and DBP < 110 mm Hg; age ≤80, followup 2.2 years	Diuretic (indapamide) with possible addition of ACE-I (perindopril) versus placebo	MMSE	Mean difference in BP between treatment groups and the control was 15 mm Hg SBP and 5.9 mm Hg DBP. Rates of dementia incidence for patients in the active treatment groups and the control groups were 33 and 38 cases per 1.000 patient-years (hazard ratio 0.86). respectively. Not significant.

BP: blood pressure, SBP: systolic blood pressure, DBP: diastolic blood pressure.