Pylypiv O. Peculiarities of the course and treatment of arterial hypertension with cognitive impairment depending on risk factors and target organ damage

The dissertation is devoted to increase the effectiveness of early diagnosis of cognitive impairment (CI) in hypertensive patients by studying risk factors, peculiarities of the daily blood pressure profile, structural and functional state of the heart, blood cholinesterase levels and evaluate the impact of antihypertensive therapy in these disorders. It was found that risk factors that significantly negatively affected cognitive functions were age of patients, duration of hypertension, overweight and obesity, decreased glomerular filtration rate, smoking and elevated levels of total cholesterol, low-density lipoprotein cholesterol, very little density lipoprotein cholesterol and triglycerides. Data were first obtained that structural and functional changes in the left ventricle, namely left ventricular hypertrophy and diastolic dysfunction of the left ventricle significantly affect cognitive decline in hypertensive patients. It was first found out that ABPM indices, namely the daily blood pressure profile, were significantly associated with worse cognitive test scores in patients with hypertension. The dynamics of cognitive indices under the influence of combined antihypertensive therapy with renin-angiotensin-aldosterone system blockers in combination with calcium channel blockers have been analyzed. Obtained results of the clinical study indicate an undeniably positive dynamics of cognitive functions in hypertensive patients with cognitive impairment while using antihypertensive therapy, which is characterized by a significant improvement in the results of neuropsychological tests.