The Correlation between Two Angiotensin-Converting Enzyme Inhibitor’s Concentrations and Cognition

Both lisinopril and enalapril are angiotensin-converting enzyme (ACE) drugs and widely used in the treatment of hypertension. Enalapril does not cross the blood–brain barrier, but lisinopril is centrally active. Our goal was to find out if there was a link between the actual concentration of ACE inhibitors and cognition and if there was a detectable difference between the two types of ACE inhibitors. Asymptomatic, non-treated patients were diagnosed by screening and the hypertension was confirmed by ambulatory blood pressure monitoring (ABPM). A battery of cognitive tests was used to assess the impact of randomly assigning participants to receive either lisinopril or enalapril. All neurocognitive functions were measured, especially the most affected by conditions of compromised perfusion pressures, such as hypertension, which are attention and executive functions. The lisinopril concentration showed a significant inverse correlation with mosaic test (coeff. = −0.5779) and seemed to have a significant negative effect on perceptual motor skills (coeff. = −0.5779), complex attention (coeff. = −0.5104) and learning (coeff. = −0.5202). Compared with enalapril, lisinopril is less successful in improving the components of cognitive functions.