Eprosartan-based hypertension therapy, systolic arterial blood pressure and cognitive function: analysis of Middle East data from the OSCAR study

Ghazi Ahmad Radaideh¹, Patrick Choueiry², Amr Ismail², Elie Eid³, Jean-Pascal Berrou⁴, Armand Sedefdjian⁵, Frank Sévenier⁶, Atul Pathak^7
1Rashid Hospital of Dubai, Dubai, United Arab Emirates; ²Abbott Gulf – Levant; ³Division of Cardiology, American University of Beirut, Beirut, Lebanon; ⁴Abbott Products Operations AG, Allschwill, Switzerland; ⁵EvidenceBased Communication (EBC), Rueil-Malmaison, France; ⁶Fovéa Group, Rueil-Malmaison, France; ⁷Departments of Clinical Pharmacology and Cardiology, Institut National de la Santé et de la Recherche Médicale U1048, Université de Toulouse-UPS, Centre Hospitalier Universitaire de Toulouse, Toulouse, France

Background: Studies have indicated a relationship between hypertension and cognitive function. The possible effect of antihypertensive therapy on cognitive disorders is therefore a matter of interest.
Materials and methods: The Observational Study on Cognitive function And SBP Reduction (OSCAR) was an open-label, multinational trial designed to evaluate the impact of eprosartan-based antihypertensive therapy on cognitive function in patients with essential hypertension. Eprosartan 600 mg/day for 6 months (with provision for additional medication as needed) was initiated in hypertensive subjects aged ≥50 years. A total of 853 patients in an intention-to-treat cohort from seven countries of the Middle East was identified for subgroup analysis.
Results: Arterial blood pressure was reduced significantly (P < 0.001) during the study: At the end of 6 months of eprosartan-based therapy, the mean (±SD) reduction from baseline was 32.1 ± 14.3/14.6.3 ± 8.6 mmHg (P < 0.001). Mean pulse pressure was reduced by 18.3 ± 13.1 mmHg (P < 0.0001 vs baseline). Blood pressure was normalized (systolic <140 mmHg and diastolic <90 mmHg) in 68.2% of patients. The overall mean Mini-Mental State Examination (MMSE) score after 6 months of eprosartan-based therapy was one-point higher than at baseline (P < 0.001). MMSE score on completion of 6 months’ follow-up was either unchanged or increased from baseline in 793 (93%) individuals and decreased in 60 (7%). Factors associated with stability of or improvement in cognitive function included MMSE score at baseline, diastolic blood pressure (DBP) at baseline, and treatment-induced change in DBP.
Conclusion: Results from the Middle East subgroup of OSCAR are supportive of the hypothesis that antihypertensive therapy based on angiotensin-receptor blocker therapy with eprosartan may be associated with preservation or improvement of cognitive function.

Keywords: hypertension, eprosartan, cognitive function, Middle East