Arterial hypertension and cognitive impairment in elderly and senile patients: basic approaches to patient management

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Abstract

The development and progression of cognitive impairment (CI), including dementia, are an important medical and social problem, especially in the context of increasing life expectancy and «aging» of the population. Arterial hypertension (AH) is a significant modifiable risk factor for development of CI. Antihypertension therapy is considered as the main proven method of preventing cognitive disorders. According to the information presented in this literature review, dihydropyridine calcium antagonists and diuretics are the most effective classes of antihypertension drugs with cerebroprotective effect, not only due to the long-term and stable maintenance of blood pressure within the target values, but also due to additional specific mechanisms. In this regard, these groups of drugs can be considered as first-line therapy for the prevention of CI in elderly and senile people with AH. Such representatives of calcium antagonists and diuretics as nitrendipine and indapamide, respectively, have the greatest evidence base for the presence of neuroprotective mechanisms.

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About the authors

Olga D. Ostroumova

Russian Medical Academy of Continuous Professional Education; I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0002-0795-8225
SPIN-code: 3910-6585

Dr. Sci, (Med.), Professor, Head of the Department of Therapy and Polymorbid Pathology n.a. Acad. M.S. Vovsin, Professor at the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases

Russian Federation, Moscow; Moscow

S. S. Telkova

Russian Medical Academy of Continuous Professional Education

Email: ostroumova.olga@mail.ru
ORCID iD: 0009-0008-6383-0016
SPIN-code: 1755-1594
Russian Federation, Moscow

K. K. Dzamihov

Russian Medical Academy of Continuous Professional Education

Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0002-8941-7018
SPIN-code: 9603-5881
Russian Federation, Moscow

A. I. Kochetkov

Russian Medical Academy of Continuous Professional Education

Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0001-5801-3742
SPIN-code: 9212-6010
Russian Federation, Moscow

S. A. Baronov

N.A. Semashko National Research Institute of Public Health

Email: ostroumova.olga@mail.ru
ORCID iD: 0009-0004-1425-9467
Russian Federation, Moscow

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