Cognitive dysfunction in middle-aged patients with arterial hypertension

O.D. Ostroumova

Russian Medical Academy of Continuous Professional Education, Moscow

Brain is the most vulnerable target for arterial hypertension, therefore, early detection of subclinical brain damage by cognitive testing is of particular importance since MRI is an expensive screening tool. A study was performed to assess cognitive functions in middle-aged persons with uncomplicated essential arterial hypertension stage 1–2. It was demonstrated that just two tests are sensitive to vascular cognitive dysfunction, i.e., MoCA (Montreal Cognitive Assessment) and TNT (Trail Making Test). Despite middle age of these patients (50.5% were diagnosed with arterial hypertension for the first time), white matter damage was identified (by MRI) in 53.7% of them as compared with 9.7% of controls. High systolic blood pressure in middle age correlates with higher risk of cognitive dysfunction in older age. Antihypertensives reduces dementia risk and improves cognitive functions. Moreover, calcium channel blockers (CCBs) demonstrate cerebroprotective class effect. Angiotensin-converting-enzyme inhibitors which penetrate blood-brain barrier can also improve cognitive functions. Considering that most patients with arterial hypertension require fixed-dose combinations (FDCs) from the very beginning of treatment, FDCs of CCBs and second component providing cerebroprotection are of particular interest. Significant improvement of thinking and attention were revealed after 6 months of the treatment with FDC of amlodipine and lisinopril (Ekvator^®).

Keywords: arterial hypertension, cognitive functions, middle age, subclinical brain damage, Montreal Cognitive Assessment score, Trail Making Test, fixed-dose combination.

For citation: Ostroumova O.D. Cognitive dysfunction in middle-aged patients with arterial hypertension. RMJ. 2020;6:40–44.