Heart failure (HF) is a progressive cardiovascular disorder associated with high morbidity, mortality, and frequent hospital readmissions, often exacerbated by cognitive impairment. Cognitive deficits, particularly in executive function and memory, affect patients’ ability to perform self-care, adhere to treatment, and manage HF effectively. Emerging evidence suggests that angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) may provide neurocognitive protection in HF patients by modulating the renin-angiotensin system (RAS), reducing neuroinflammation, and improving cerebral perfusion. While animal studies consistently show cognitive benefits, human studies have produced mixed results, though some indicate improved cognitive outcomes with higher doses and longer treatment duration. This secondary analysis of cross-sectional data examines the potential role of ACE inhibitors and ARBs in preserving cognition among HF patients. Findings highlight a promising association between ACE inhibitor therapy and cognitive stability, underscoring the need for further longitudinal and randomized studies to validate these neuroprotective effects and inform clinical practice.