FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

WIFE'S MEMORY PROBLEMS MIGHT BE DUE TO MEDICATION

Question: My wife, who is 67 years old, has been taking high blood pressure medication for the last three years. Since she has been on Kerlone and Lotensin her blood pressure medications her memory is not as good as it used to be. Her doctor doesn't attribute her memory problems to the medication. Instead, he wants her to have an expensive MRI. In general terms, is there some possibility that her medication could be causing her memory problems?

Answer: High blood pressure defined as greater than 140 over 90 is a very common problem in the United States, affecting an estimated 50 to 60 million Americans. That is about one out of every five citizens, but in the over-65 population, the numbers are even more dramatic. Some experts estimate that as many as half of the people in this age group have high blood pressure. Despite the prevalent nature of the problem, only half of those with high blood pressure are aware they have it and only part of these about one third of the total are getting proper treatment. Happily, your wife is one of the fortunate one third.

High blood pressure is a serious concern because it increases the risk of heart attack, heart failure, kidney failure and stroke. Treatment that brings blood pressure down to normal levels reduces the risk of having these undesirable conditions. In previous years the definition of "normal" was a bit higher for those over 65, but newer studies have shown that 120 over 80 is ideal, and pressure that is continuously above 140 over 90 regardless of age is associated with increased risk.

Most individuals have "essential hypertension." This is a fancy term that means the blood pressure is elevated without a specific known cause. That makes it possible to use a wide variety of medications to bring the pressure down to normal. Your wife takes two types of medication. The Kerlone is in the family of medications called beta-blockers, while the Lotensin is in the ACE inhibitor family. They are good medications.

All medications have some potential for side effects that is, unintended consequences that it would be nice to avoid. Drugs in the beta-blocker family can cause subtle problems with memory as well as bring on depression, which often masquerades as memory difficulties. So you are correct. The medication may be the source of your wife's memory problems.

Memory is a very complex process that we take for granted most of the time. Because of its complexity, there are many health problems that can interfere with it. I'm suspicious that your wife's doctor has seen subtle signs that make him or her concerned that her memory impairment may be due to a condition more serious that just the side effects of her blood pressure medication. That is probably why he or she has requested an MRI. On the other hand, another medication that isn't in the beta-blocker family could probably replace the Kerlone she takes. If her memory problems are due to the medication, I would expect them to improve within three or four weeks after switching.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.