My 83 year old husband has vascular dementia. his blood pressure is slightly high. he will be put on blood pressure medicine. im afraid his dementia will get worse. do ace inhibitors work better than blood pressure medicine for preventing dementi?

The blood pressure needs to be controlled to prevent worsening of dementia. The ace inhibitors will not have effect on dementia other than by controlling high blood pressure and preventing its adverse effects of on the nervous system. The adverse effects of high blood pressure are on the end vasculature hence control blood pressure.

Your worries are understandable as dropping blood pressure may affect brain perfusion as well. Goal blood pressure is more flexible given your husbands age and all efforts should be made to decrease his drug load. Ace inhibitors are used many times as first line antihypertensives due to beneficial secondary cardiovascular effects and relatively predictable side effect profile.

Certainly, hypertension needs to be controlled, especially in the case of vascular brain issues, but preventative interventions are likewise needed regarding stroke. Memory enhancing agents are indeed required to assist cognitive issues. So, there appears to be three categories to address. No problem with ACE drugs, but do check if BP drops too low.