Shmanko O. Clinical and diagnostic predictors of the development of cognitive impairment and their management in patients with arterial hypertension.

The dissertation is devoted to establishing of the predictive factors of cognitive impairment development and of their adequate management in patients with arterial hypertension, considering effects of clinical manifestations of arterial hypertension, of structural and functional state of the heart, of disorders of lipid metabolism and hemostasis, and of the severity of neuropsychological impairment. Among the predictive factors that contribute to the development of cognitive impairment in patients with arterial hypertension there are age, duration of disease, degree of arterial hypertension, also an increase in body mass index, especially over 35 kg/m2, and an elevation of low-density lipoprotein and triglyceride blood levels. Hypercoagulation signs are early diagnostic predictors of risk of cognitive impairment emergence in patients with arterial hypertension. Among the predictive factors of the development of cognitive impairment in patients with arterial hypertension there are reduction in the left ventricular ejection fraction, increase of the thickness of interventricular septum and posterior wall of the left ventricle, and an increase of left ventricle end-diastolic size. Addition of piracetam and meldonium to standard treatment improves the clinical condition of patients with arterial hypertension and cognitive impairment. The effectiveness of the fixed drug combinations of lisinopril with meldonium and enalapril with nitrendipine in arterial hypertension patients with cognitive impairment could be considered as clinically meaningful because of cerebro-protective effect.