Does the Antihypertensive Therapy with Calcium-Channel blockers improve the cognitive function?: A review of evidences

Abstract

Los bloqueantes de los canales de calcio (BCC) son un grupo de drogas con estructuras químicas heterogéneas, entre ellas verapamil, ditiazen y dihidropiridinas. Introducidas en la medicina clínica en el año de 1960, son drogas de prescripción frecuente en el tratamiento de los desordenes cardiovascular. Los bloqueantes de los canales de calcio son ampliamente utilizados en clínica en razón de que inducen vasodilatación arterial inhibiendo los canales voltaje dependientes del calcio del músculo cardiaco y del músculo liso vascular, modificando así la concentración de calcio intracelular fomentando de esa forma la relajación muscular. Hipertensión, diabetes, fibrilación auricular, demencia multiinfarto, enfermedad de alzehimer y la isquemia cerebral son algunas nuevas indicaciones en investigación para el uso de bloqueantes de los canales de calcio. De nuestra revisión se desprende que los efectos atribuidos a los BCC en la función cognitiva se ubican todavía en el terreno de la investigación. Trabajos futuros aportarán claridad sobre el tema.

ABSTRACT
As a group, verapamil, diltiazem and dihydropyridines are commonly named calcium channel blockers. Introduced into clinical medicine in the 1960s, they are among the most frequently prescribed drugs for the treatment of cardiovascular diseases. All calcium channel blockers that have been approved for clinical use induce vasodilation and lowering blood pressure by inhibiting the voltage-dependent calcium channels in vascular smooth muscle at significantly lower concentrations than are required to interfere with the release of intracellular calcium or to block receptor-operated calcium channels. They relax arterial smooth muscle and have little or not effect on most venous beds and hence do not affect cardiac preload. In addition to their proved cardiovascular effects, preclinical and clinical evidence shows that calcium channel blockers may be useful in the treatment of diverse central nervous system disorders such as cerebral ischemia, epilepsy, depression and dementia. Hypertension, diabetes, smoking and atrial fibrillation are well-recognized risk factors for stroke and multiinfarct dementia which may develop to the clinical diagnosis of dementia know as Alzheimer disease. An acquired deficit in memory function, problem solving orientation, and abstraction, decreases the capacity of an individual to function in an independent manner and are major components of diseases related to dementia. In this context, the use of calcium channel blockers to treat hypertensive patients and its relation to cognitive function is reviewed in an attempt for elucidate any positive or negative connection between high blood pressure, calcium channel blocker treatment and cognitive function.