Krotova V. The quality of life of patients with arterial hypertension, depending on the vegetative status and cognitive dysfunction

The dissertation is devoted to the substantiation of the necessity of early diagnosis of cognitive impairment in patients with stage II arterial hypertension and optimization of treatment based on the study of the cerebrovascular reserve, cognitive functions, the status of the autonomic nervous system, and the quality of life. The necessity of early detection of indicators of cognitive functions in patients with arterial hypertension of stage II as a marker of brain damage - a target organ of the risk of development of cardiovascular events is proved. It is determined that the most informative and rational in real medical practice is the study of cognitive functions on the scale of MоCA in comparison with other methods of neuropsychological testing. It is recommended for the diagnosis of early signs of brain damage and cognitive impairment in arterial hypertension as well as monitoring of the effectiveness of medical rehabilitation to introduce the use of functional respiratory tests with the definition of the cerebrovascular reserve according to the data of the vasomotor reactivity index. It is suggested when determining the high variability of systolic blood pressure according to DMBP (probability of development of CD exceeds 50 %, high risk, if the degree of variability of SBP in the daytime is more than 12 mm Hg and at night ̶ more than 10 mm Hg as critical levels) and elevated level of personal anxiety in patients with arterial hypertension of stage II to prescribe phenibut 1000 mg per day for at least 1.5 months. When establishing non-demention cognitive dysfunction in patients with stage II arterial hypertension, it is advisable, in addition to personalized antihypertensive therapy, to prescribe neuroprotective agents that affect memory, attention, and speed of sensorimotor reactions in order to improve cognitive function, namely, a fixed combination of phenibut and ipidacrine (300 mg/5 mg) three times a day for 1.5 months to stop the progression of cognitive dysfunction, reduce anxiety and improve quality of life.