classes of antihypertensive medication including arbs, beta-blockers, diuretics, and ace inhibitors, reveal that pharmacological treatments have overall cerebroprotective effects however, the effects vary depending on drug class and its mechanisms. angiotensin-converting enzyme inhibitors angiotensin-converting enzyme (ace) inhibitors essentially block the conversion of ang i to ang ii. they cause relaxation of the blood vessels as there are less ang ii molecules (vasoconstrictor) circulating, increase natriuresis, decrease blood volume, all of which culminate in lowering blood pressure. enalapril, benazepril, perindopril, and ramipril are among commonly prescribed ace inhibitors clinically. angiotensin receptor blockers angiotensin receptor blockers (arbs) antagonize the action of ang ii by binding and inhibiting angiotensin ii type 1 receptor. in doing so, arbs block vasoconstriction, promote natriuresis, and reduce oxidative stress. studies show that the vasodilator ability of vessels are impaired in hypertensives which causes brain perfusion to decrease significantly, influencing cognitive function. aces and arbs improve cerebral perfusion in hypertensive patients. losartan, irbesartan, valsartan, olmesartan, and azilsartan, are common arbs that are clinically available. angiotensin type 2 receptor agonists at2r agonists cause vasodilation, exerting hypotensive effects. in animal models of ischemia, activation of at2r is protective as it reduces the infarct area by increasing cerebral perfusion, decreases superoxide production, and promotes neuronal cell differentiation and neuritis growth, which all come together to reduce axonal degeneration and inflammation. beta-blockers beta-blockers beta-blockers are competitive antagonists of the adrenergic beta receptor, blocking the binding sites of epinephrine and norepinephrine. they lower blood pressure by a raas independent mechanism, reducing plasma renin activity and ang ii levels. propranolol, atenolol, bupranolol, timolol, are some examples of clinically available beta-blockers.