Taranchuk V. Cognitive function and structural and functional changes of the myocardium in hypertensive patients with different risk factors on the background of antihypertensive treatment.

In the thesis, the features of cognitive function in patients with essential hypertension(EH) and in patients with essential hypertension and concomitant diabetes mellitus (DM) type 2 and it changes depending on various risk factors on the background of antihypertensive treatment. It is established that in patients with essential hypertension compared with patients without GC, which is comparable by age and gender, a decrease in cognitive function mainly through neurodynamic component. In addition, the presence of concomitant diabetes mellitus type 2 in patients with essential hypertension creates an additional negative impact on cognitive function. Found that in middle-age with essential hypertension syndrome of mild cognitive impairment (MCI) diagnosed in 18% of patients, whereas in type 2 diabetic joining this figure rises to 57%. Risk factors of MCI are almost the same as for patients with essential hypertension and patients with essential hypertension and concomitant diabetes. Lower rates of cognitive function were found in both groups of patients in the presence of left ventricular hypertrophy, obesity, prolonged GC, hypercholesterolemia. It was found that inadequate BP reduction at night reduces the cognitive tests and on the main scale. Indicators of cognitive function in patients with circadian profile of the type of night-picker significantly worse than in patients with a profile dipper and non-dipper. The relationship of average values of blood pressure and cognitive function is nonlinear. Thus, the optimal level for preserving cognitive function is SBP 130-139mmHg within and DBP 75-85 mmHg at the level of nocturnal blood pressure reduction of 8-10%. Long-term combination therapy of ACE inhibitors with calcium antagonists showed the highest result for the preservation of cognitive function compared with other recommended regimens.