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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
[Cognitive functions and extracranial circulation in patients with hypertonic crisis]
Klinicheskaia Meditsina
|May 11, 2013
Summary
Antihypertensive therapy improved cerebral blood flow in patients with hypertensive encephalopathy but did not fully resolve cognitive issues. Infedipine showed a slight advantage over enalaprilate in improving verbal memory.
Area of Science:
- Neurology
- Cardiology
- Pharmacology
Background:
- Chronic hypertension (AH) can lead to acute encephalopathy, impacting cognitive function and cerebral circulation.
- Patients often present with predemential or mild cognitive disorders, frequently accompanied by reduced extracranial circulation.
- Impaired extracranial blood flow significantly contributes to cognitive dysfunction during hypertensive crises.
Purpose of the Study:
- To investigate the effects of enalaprilate and infedipine on cognitive functions and extracranial circulation in patients with AH and acute encephalopathy.
- To compare the cerebroprotective and memory-enhancing effects of enalaprilate and infedipine.
- To identify predictors of residual cognitive dysfunction after antihypertensive therapy.
Main Methods:
- Studied 60 patients with chronic AH complicated by acute encephalopathy.
- Assessed cognitive functions and extracranial circulation (including common carotid artery blood flow).
- Administered antihypertensive therapy with enalaprilate and infedipine, evaluating outcomes 2 weeks post-crisis.
Main Results:
- Antihypertensive therapy improved extracranial blood flow and vessel indices but failed to eliminate mild cognitive disorders in 65% of patients.
- Visual-spatial orientation recovery was more frequent than verbal auditory memory restoration.
- Infedipine demonstrated a more favorable effect on verbal auditory memory compared to enalaprilate, with both showing similar angio- and cerebroprotective effects.
- Patient age and hemodynamic parameters at 2 weeks post-therapy predicted residual cognitive dysfunction.
Conclusions:
- While antihypertensive therapy improves hemodynamics, residual cognitive deficits are common after hypertensive encephalopathy.
- Infedipine may offer a slight advantage over enalaprilate for specific cognitive functions, particularly verbal memory.
- Age and hemodynamic status are crucial predictors for long-term cognitive outcomes in these patients.
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