Mazur Y. Cardio-vascular remodelling and cognitive disorders in patients with hypertensive disease, their relationship and dynamics under the influence of complex drug therapy.

A The work is devoted to optimization of diagnostics and treatment of patients with hypertensive disease (HD) and cognitive disorders (CD).Development and progression of CD was found to be associated with the age of patients, level of education and occupational activities, the stage of HD, the degree of arterial hypertension and its duration, regular treatment, association with IHD, strokes in the past and chronic insufficiency of brain circulation. Associative correlations were determined between CD and the following instrumental indices: daily average values of arterial pressure (AP) and its variability, early awakening rate and index of systolic AT time, myocardium weight of the left ventricle, relative thickness of its walls, the degree of thickening of “intima-media” complex, presence and degree of stenosis of carotid arteries, increase of their peripheral resistance and rigidity. Addition of combined cerebroprotective drug olatropil in complex therapy during three months of treatment contributed to cognitive function in 62.5-76.7% of patients who took the course of two- and three-component antihypertensive therapy. The most significant factors in prognosis of positive cognitive effect of olatropil are: the age of the patients (<=63 years), presence of professional activities, increased body weight (IMT>=30kg/m2 ), atherosclerotic plaques in the basin of carotid artery, high variability of systolic AP(>=16 mmHg), severity of CD >=22 points as well as severity of vegetative dysfunction by the questionnaire of Wein >=38 points. On the basis of these factors the prognostic scale of probable high cognitive effect of olatropil was worked out.