Favourable effects of nilvadipine on cognitive function and regional cerebral blood flow on SPECT in hypertensive patients with mild cognitive impairment

Objective We compared the effects of nilvadipine and amlodipine on the cognitive function and regional cerebral blood flow (rCBF) in patients with mild cognitive impairment (MCI) and hypertension. Methods Twelve patients with MCI and hypertension were randomly assigned to receive nilvadipine or amlodipine for 12-16 weeks. Before and after treatment all patients underwent neuropsychological evaluation and single photon emission computed tomography (SPECT) studies with N-isopropyl-p-[123I]iodoamphetamine. Results Both nilvadipine (n=6) and amlodipine (n=6) groups had similar significant reduction in systolic and diastolic blood pressure after treatment. The Logical Memory subscore of the Wechsler Memory Scale-Revised increased significantly in the nilvadipine group, but not in the amlodipine group after treatment. Although SPECT demonstrated no significant differences in rCBF deficits at baseline between the two groups, the nilvadipine group showed an improvement of rCBF in the left frontal lobe, while the amlodipine group showed a decrease of rCBF in the left temporal lobe. Conclusion Our results suggest that nilvadipine, a highly lipophilic agent that easily penetrates the central nervous system, may have additional benefits and be potentially useful for the treatment of patients with MCI and hypertension.