Although not tested specifically in this study, ARBs in general may impact many pathological mechanisms in Alzheimer’s disease including the neurovascular unit, neuroinflammation, neuronal cell survival, blood brain barrier integrity, endothelial dysfunction, and hemodynamic compromise.44,45 Candesartan may have unique effects in the brain that explain these trial results such as its effect on PPAR-gamma, ischemia/reperfusion protection, angiogenesis, extracellular matrix regulation and chromosomal maintenance.46-49. This evidence concerns the gene PPARG and Alzheimer disease.